Some Metabolic and Nutritional Changes Associated with Injury

Abstract

A. Introduction An understanding of the metabolic response to injury is of basic importance to medicine. It is the aim of this paper to present some known facts about the mechanism and significance of some of the metabolic reactions to injury and to point out a few of the gaps in our information which seem to us susceptible to present-day research techniques. The usual features of the early metabolic response to injury of previously normal patients may be summarized as follows: increased heat production; weight loss; negative nitrogen, potassium, and phosphorus balances; disturbed carbohydrate utilization; tendency to ketosis; retention of sodium, chloride, and water, and a derangement in the metabolism of watersoluble vitamins. These changes are also usually accompanied by involution of lymphoid tissue and thymus, lymphopenia and eosinopenia, leukocytosis, adrenal cortical hypertrophy with associated depletion of cholesterol and ascorbic acid, and an increase in certain adrenal hormones (medullary and