22 - Trauma and Nutrition Flashcards
1
Q
Phases of response to trauma
A
1: clinical shock
2: hypercatabolic state
3: recovery (anabolic state)
2
Q
Phase one
A
2-6hrs after injury
Cytokines, catecholamines and cortisol secreted
tachycardia, high resp rate, peripheral vasoconstriction, hypovolaemia
1°aim is to stop bleeding and prevent infection
3
Q
Phase two
A
2 days after injury Catecholamines Glucagon ACTH -> cortisol Higher O2 consumption higher metabolic rate negative nitrogen balance glycolysis reserves deplted lipolysis
1° aims to avoid sepsis and provide adequate nutrition
4
Q
Phase 3
A
3-8 days
Gradual restoration of protein synthesis, N2 levels, fat stores, muscle strength.
Adequate nutrition supply is critical at this stage. Refeeding syndrome risk. May last a few weeks/ a few months. Obesity paradox
5
Q
Five cardinal signs of inlammation
A
Heat Redness Swelling Pain Loss of function
6
Q
Endocrine effects of cytokines
A
Increase in ACTH -> more cortisol
Higher glucagon
Catecholamines go up
Less growth hormone and insulin
