caa a22 4500 475801512 CHVBK 20180406123738.0 cr unu---uuuuu 170329e20000601xx s 000 0 eng 10.1007/s002689910113 doi (NATIONALLICENCE)springer-10.1007/s002689910113 Wilmore Douglas W. Department of Surgery, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, Massachusetts 02115, USA, USA aut Metabolic Response to Severe Surgical Illness: Overview [Elektronische Daten] [Douglas W. Wilmore] Abstract.: Severe surgical illness results in metabolic responses that mobilize substrate (amino acids and fatty acids) from body stores to support vital organs, enhance resistance to infection, and ensure wound healing. Central to this process is the redistribution of body protein, which moves from skeletal muscle to support the central viscera. If unsupported, this protein-wasting state could result in prolonged convalescence, diminished immunity, and poor wound healing. Present evidence suggests that the central nervous system plays a major role in regulating this protein catabolic response. Infusing exceedingly small quantities of the proinflammatory cytokines into the brain can mimic injury responses, and central cytokine blockade may be one therapeutic approach to attenuating these responses safely in the future. Additional evidence also demonstrates that the function of the hypothalamus and anterior pituitary is dampened during the later stages of severe surgical illness, and the possibility of hormonal replacement therapy needs to be explored. 2000 by the Société Internationale de Chir, 2000 World Journal of Surgery Springer-Verlag 24/6(2000-06-01), 705-711 0364-2313 24:6<705 2000 24 268 https://doi.org/10.1007/s002689910113 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689910113 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Wilmore Douglas W. Department of Surgery, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, Massachusetts 02115, USA, USA aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/6(2000-06-01), 705-711 0364-2313 24:6<705 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer