RT Book, Section
A1 Orellana, Renán A.
A1 Coss-Bu, Jorge A.
A2 Goday, Praveen S.
A2 Mehta, Nilesh M.
SR Print(0)
ID 1105178604
T1 Energy and Macronutrient Requirements in the Critically ill Child
T2 Pediatric Critical Care Nutrition
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-179852-5
LK accesspediatrics.mhmedical.com/content.aspx?aid=1105178604
RD 2024/04/20
AB The  metabolic  response  to  tissue  injury  and  the  stress  of  critical  illness  is  a  cascade  of  events  supported  by  an  intricate,  complex  network  of  mediators,  cytokines,  growth  factors,  and  hormones  that  significantly  alter  energy  requirements.1  The  initial  response  after  injury  is  manifested  by  a  decrease  in  energy  expenditure  (the  ebb  phase),  lasting  2  to  3  days  and  aimed  at  the  preservation  of  energy;  this  is  followed  by  the  flow  phase,  which  is  characterized  by  an  increase  in  energy  expenditure  and  a  catabolic  response  that  varies  in  duration,  depending  of  the  nature  of  the  initial  insult.2  Critically  ill  patients  are  characterized  by  alterations  in  the  metabolism  of  carbohydrates,  proteins,  and  lipids.  During  critical  illness,  typical  alterations  include  increased  secretion  of  cortisol,  glucagon,  and  catecholamines;  decreased  secretion  of  insulin-like  growth  factor  1  (IGF-1);  and  resistance  to  the  combined  effects  of  insulin  and  growth  hormone3  and  growth  hormone  alone.4