Rapid loss of skeletal muscle & adipose tissue
Description: Rapid loss of skeletal muscle adipose tissue Critically Ill Patient: sepsis, major surgeries, trauma (inflammatory cytokines) Altered Metabolism in the ICU: Pathogenesis and clinical findings Gluconeogenesis in Liver (150 200
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slide1. Rapid loss of skeletal muscle & adipose tissue Critically Ill Patient: sepsis, major surgeries, trauma (↑inflammatory cytokines) Altered Metabolism in the ICU: Pathogenesis and clinical findings ↑ Gluconeogenesis in Liver
(150 – 200% increase in glucose production rate with moderate/severe infection) ↑ Free
glycerol ↑ Free fatty acids ↑Post ICU Frailty ↑ Catecholamine's Authors:
Sean Crooks
David Lincoln
Reviewers:
Lindsey McGregor RD Glycogen
depleted ↑ Peripheral muscle protein catabolism ↑Immunosuppression ↓ Body Weight and Lean Muscle Mass ↑CRP & acute phase proteins ↑Glucagon ↑ Cortisol ↑ Lipolysis Bed rest ↑ Insulin
resistance Glycogenolysis in liver and skeletal tissue (hours) ↑ Free amino acids ↓ Albumin/
Pre Albumin & negative acute phase proteins ↑Impaired Wound Healing ↓ Respiratory Function ↑Length of Stay ↑ Hormone sensitive lipase (adipose tissues) Hormone mediated impairment of ketogenesis in the liver Hormone mediated impairment of FFA metabolism intracellularly ↑ Serum Glucose ↑ Vascular permeability ↓ Serum
Albumin ↑ 20 -60% in basal energy expenditures ↑ Inflammatory cytokines Glycogen depleted Insufficient feeding / NPO for tests procedures ↑Edema<br>
(150 – 200% increase in glucose production rate with moderate/severe infection) ↑ Free
glycerol ↑ Free fatty acids ↑Post ICU Frailty ↑ Catecholamine's Authors:
Sean Crooks
David Lincoln
Reviewers:
Lindsey McGregor RD Glycogen
depleted ↑ Peripheral muscle protein catabolism ↑Immunosuppression ↓ Body Weight and Lean Muscle Mass ↑CRP & acute phase proteins ↑Glucagon ↑ Cortisol ↑ Lipolysis Bed rest ↑ Insulin
resistance Glycogenolysis in liver and skeletal tissue (hours) ↑ Free amino acids ↓ Albumin/
Pre Albumin & negative acute phase proteins ↑Impaired Wound Healing ↓ Respiratory Function ↑Length of Stay ↑ Hormone sensitive lipase (adipose tissues) Hormone mediated impairment of ketogenesis in the liver Hormone mediated impairment of FFA metabolism intracellularly ↑ Serum Glucose ↑ Vascular permeability ↓ Serum
Albumin ↑ 20 -60% in basal energy expenditures ↑ Inflammatory cytokines Glycogen depleted Insufficient feeding / NPO for tests procedures ↑Edema<br>