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- W787128 abstract "textabstractCritical illness can be defi ned as “a life threatening medical or surgical condition usuallyrequiring intensive care unit (ICU) level care“ [1]. It mostly results from infection, sepsisand trauma (including surgery and burns). Th ese conditions are accompanied by similarphysiological and biochemical responses, which have been termed the systemic infl ammatoryresponse syndrome (SIRS) [2]. Th e associated major metabolic changes are also known as theacute stress response. From an evolutionary point of view these responses are required for the“fi ght, fl ight, fright” reaction when encountering a thread, to mobilise fuels for tissues thatare activated [3-5]. A key feature is increased sympathetic nervous system activity, resultingin increased levels of adrenaline and glucocorticoids. Subsequently, immune cells are activatedand pro-infl ammatory cytokines secreted, which trigger further metabolic changes. Inaddition, insulin secretion is increased as well as the counter regulatory hormones glucagon,cathecholamines, cortisol and growth hormone. As a result, glucose production is increasedvia increased glycogenolysis and gluconeogenesis and insulin resistance develops, leading tohyperglycemia. Also, fat is mobilised (lipolysis) and fat oxidation and ketone body formationare increased, while muscle protein breakdown is stimulated to provide amino acids forprotein synthesis in proliferating cells, the production of acute phase proteins and other peptides(e.g. cytokines) and for gluconeogenesis. Th us, protein turnover is increased, with bothincreased protein breakdown and protein synthesis. Protein synthesis, however, is stimulatedto a lesser extent than protein breakdown, resulting in net protein loss, i.e. protein catabolism.In addition, the increased substrate cycling results in increased energy expenditure, becauseboth protein synthesis and breakdown consume ATP." @default.
- W787128 created "2016-06-24" @default.
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- W787128 date "2012-09-06" @default.
- W787128 modified "2023-09-23" @default.
- W787128 title "Protein Anabolism in Critically Ill Children: Pathophysiological aspects and interventional challenges" @default.
- W787128 hasPublicationYear "2012" @default.
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