Study of the Endocrine &
Metabolic Dysfunction & Assessment of
Hormonal Interventions in a Novel In Vivo
Experimental Model of Critical Illness

By Frank Weekers
December 2003
Leuven University Press
ISBN: 90-5867-343-X
153 pages, Illustrated, 6 " x 9 "
$65.00 Paper Original

This is a Ph.D. dissertation. The provision of sufficient oxygen and substrates to cells such that the organs maintain their function, is essential for survival. This is achieved by a coordinated function of cardiovascular, respiratory and metabolic processes. If one or more of these vital functions fail, an imminent threat for life ensues. Intensive care medicine involves monitoring and support of patients who are threatened in their vital functions after major trauma or surgery or following severe illness using pharmacological and technical interventions designed to maintain or restore homeostasis.

The aggression of an illness or trauma onto the organism is accompanied by immediate, complex changes in metabolism, which presumably contribute to survival. Within hours and during the first few days following a severe insult, patients develop a syndrome of hypermetabolism comprising clinical manifestations such as fever, tachypnea and a hyperdynamic cardiovascular state accompanied by leucocytosis, hyperglycemia, hyperlactatemia, lipolysis, muscle protein hypercatabolism and altered hepatic protein synthesis. The main purpose of this orchestrated response is delivering sufficient amounts of substrates to wounded tissues so that healing can progress uncomplicated. When the underlying disease resolves, the stress response abates and recovery ensues. However, in the modern era of intensive care, patients survive conditions that were previously lethal. Recovery from such severe insults may take weeks and the prolongation of the hypermetabolic response induces profound erosion of lean body mass, which is resistant to feeding.

Acta Biomedica Lovaniensia, No. 301

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