期刊
CRITICAL CARE CLINICS
卷 34, 期 1, 页码 81-+出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.ccc.2017.08.006
关键词
Sepsis; Growth hormone; Thyroid hormone; Cortisol; Hyperglycemia; Insulin; Nutrition; Endocrine
资金
- Clinical Research Foundation of UZ Leuven, Belgium
- Research Foundation Flanders
- Methusalem Program - Flemish Government [METH/14/06]
- European Research Council under the European Union's Seventh Framework Program (FP7 ERC Advanced Grant) [321670]
Sepsis induces profound neuroendocrine and metabolic alterations. During the acute phase, the neuroendocrine changes are directed toward restoration of homeostasis and also limit unnecessary energy consumption in the setting of restricted nutrient availability. Such changes are probably adaptive. In patients not recovering quickly, a prolonged critically ill phase may ensue, with different neuroendocrine changes, which may represent a maladaptive response. Whether stress hyperglycemia should be aggressively treated or tolerated remains a matter of debate. Until new evidence from randomized controlled trials becomes available, preventing severe hyperglycemia is recommended. Evidence supports withholding parenteral nutrition in the acute phase of sepsis.
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