Response to surgery

Apr 15th, 2015
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RESPONSE TOSURGERYCytokines: TNFThe Metabolic Response:Substrate ExchangeCytokines and CellularResponseINTRODUCTIONTypes of injuryAccidentalDeliberateThe overall goal of response is homeostatic restoration topreinjury stateMetabolic response is not always beneficial , some sytemiceffects can be deleterious to remote organsGoal of modern surgical care is to blunt the metabolicresponse henceMinimise/Elimiate remote injuryReduce recovery timesSystemic ResponseBalance between Proinflammatory ActivationResponseof responses Counterinflammatory TargetsResponserestoration of homeostasisPURE/UNMODIFIED METABOLICREPONSEEBB PHASEImmediate postinjuryCorresponds to traumatic shock before resuscitation measures are institutedResuscitation results in 2 classes of shockFLOW PHASECatabolic PhaseReversible shockIrreversible shockLasts about a week postinjuryFeature: Net ve N2 balance: protein; fat & weight lossANABOLIC PHASENet gsin of protein and fatLasts 2-4 weeksMediators of the ResponseThe Acute Inflammatory ResponseThe EndotheliumThe Autonomic Nervous SystemEndocrine ResponseCellular ResponseThe Inflammatory ResponseMediated byTypes of effectsParacrineEndocrineOther Pro -inflammatory mediators are releasedInflammatory

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