Carbohydrate Metabolism
- Blood glucose concentrations increase 1 after trauma:
- Stimulated by cortisol and catecholamines
- Due to increased hepatic glycogenolysis and gluconeogenesis 1
- Peripheral glucose utilisation also decreases 1
- Increase in concentration proportional to the degree of injury
- Hyperglycaemia persists due during catabolic phase:
- Usual homeostatic mechanisms ineffective
- Hormones continue to promote glucose production
- Relative lack of insulin and peripheral insulin resistance observed 1
(Max 2)
Protein Metabolism
- Protein catabolism occurs to mobilise amino acids 1:
- Stimulated by cortisol
- Amino acids used for energy or converted to acute-phase proteins
- Predominantly skeletal muscle is broken down 1:
- Results in marked wasting and weight loss
- Visceral protein also catabolised 1:
- Can predispose to organ dysfunction
(Max 2)
Fat Metabolism
- Increased lipolysis mobilising triglycerides to glycerol and fatty acids 1
- Plasma levels may remain unchanged:
- Glycerol acts as substrate for gluconeogenesis in the liver 1
- Fatty acids re-esterized converted to ketone bodies 1
- Glycerol acts as substrate for gluconeogenesis in the liver 1
- Stimulated by cortisol, catecholamines and growth hormone
(Max 2)