Title |
"Metabolic staging" after major trauma - a guide for clinical decision making?
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Published in |
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, June 2010
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DOI | 10.1186/1757-7241-18-34 |
Pubmed ID | |
Authors |
Philip F Stahel, Michael A Flierl, Ernest E Moore |
Abstract |
Metabolic changes after major trauma have a complex underlying pathophysiology. The early posttraumatic stress response is associated with a state of hyperinflammation, with increased oxygen consumption and energy expenditure. This hypercatabolic state must be recognized early and mandates an early nutritional management strategy. A proactive concept of early enteral "immunonutrition" in severely injured patients, is aimed at counterbalancing the negative aspects of hyperinflammation and hypercatabolism in order to reduce the risk of late complications, including infections and posttraumatic organ failure. Recently, the concept of "metabolic staging" has been advocated, which takes into account the distinct inflammatory phases and metabolic phenotypes after major trauma, including the "ischemia/reperfusion phenotype", the "leukocytic phenotype", and the "angiogenic phenotype". The potential clinical impact of metabolic staging, and of an appropriately adapted "metabolic control" and nutritional support, remains to be determined. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Unknown | 1 | 100% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 1 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Denmark | 1 | <1% |
Tanzania, United Republic of | 1 | <1% |
Unknown | 119 | 98% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Bachelor | 16 | 13% |
Student > Postgraduate | 15 | 12% |
Researcher | 14 | 12% |
Other | 13 | 11% |
Student > Master | 13 | 11% |
Other | 28 | 23% |
Unknown | 22 | 18% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 59 | 49% |
Nursing and Health Professions | 15 | 12% |
Biochemistry, Genetics and Molecular Biology | 4 | 3% |
Psychology | 2 | 2% |
Agricultural and Biological Sciences | 2 | 2% |
Other | 9 | 7% |
Unknown | 30 | 25% |