TY - CHAP M1 - Book, Section TI - Energy and Macronutrient Requirements in the Critically ill Child A1 - Orellana, RenĂ¡n A. A1 - Coss-Bu, Jorge A. A2 - Goday, Praveen S. A2 - Mehta, Nilesh M. PY - 2015 T2 - Pediatric Critical Care Nutrition 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 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1105178604 ER -