PMID: 15373956Sep 18, 2004Paper

Endocrine modifications and interventions during critical illness

The Proceedings of the Nutrition Society
Frank Weekers, Greet Van den Berghe

Abstract

The ongoing hypermetabolic response in patients with prolonged critical illness leads to the loss of lean tissue mass. Since the cachexia of prolonged illness is usually associated with low concentrations of anabolic hormones, hormonal intervention has been thought to be beneficial. However, most interventions have been shown to be ineffective and their indiscriminate use even causes harm. Before considering endocrine intervention in these frail patients, a detailed understanding of the neuroendocrinology of the stress response is warranted. It is now clear that the acute phase and the later phase of critical illness behave differently from an endocrinological point of view. The acute stress response consists primarily of an actively-secreting pituitary in the presence of low circulating peripheral anabolic hormones, suggesting resistance of the peripheral tissues to the effects of anterior pituitary hormones. However, when the disease process becomes prolonged, there is a uniformly-reduced pulsatile secretion of anterior pituitary hormones with proportionally reduced concentrations of peripheral anabolic hormones. The origin of this suppressed pituitary secretion is located in the hypothalamus, as hypothalamic secretagogues ca...Continue Reading

References

Mar 15, 1979·The New England Journal of Medicine·D F GardnerR D Utiger
Sep 1, 1978·Clinical Endocrinology·C WangR T Yeung
Jul 1, 1992·Metabolism: Clinical and Experimental·J MøllerJ Weeke
Jan 1, 1991·Hormone Research·U Keller, J M Miles
Nov 1, 1989·JPEN. Journal of Parenteral and Enteral Nutrition·A P RobinJ A Barrett
Nov 1, 1988·Archives of Surgery·M S DahnL A Jacobs
Jun 1, 1982·The Journal of Clinical Endocrinology and Metabolism·V BacciT B Kaplan
Sep 1, 1996·Critical Care Medicine·G Van den Berghe, F de Zegher
Mar 1, 1996·European Journal of Clinical Investigation·W LiaoB Angelin
Jul 1, 1997·Metabolism: Clinical and Experimental·L GamrinJ Wernerman
Jun 5, 1998·The American Journal of Physiology·M K AngeleI H Chaudry
Nov 7, 1998·FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology·C CostaF Bosch
Nov 25, 1998·Thyroid : Official Journal of the American Thyroid Association·E FliersD F Swaab
Dec 24, 1998·JAMA : the Journal of the American Medical Association·D K HeylandJ W Drover
Sep 9, 1999·The New England Journal of Medicine·J TakalaC J Hinds
Jul 11, 2001·Critical Care Medicine·D W HartD N Herndon
Oct 6, 2001·Critical Care Medicine·A A FerrandoR R Wolfe
Oct 30, 2001·The New England Journal of Medicine·D N HerndonR R Wolfe
Jan 12, 2002·Hormone Research·P M StewartJ W Tomlinson
Jan 17, 2002·The New England Journal of Medicine·G van den BergheR Bouillon
Jan 22, 2002·Best Practice & Research. Clinical Endocrinology & Metabolism·N StathatosL Wartofsky
Jul 5, 2003·The Journal of Clinical Endocrinology and Metabolism·Robin P PeetersGreet Van den Berghe

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Citations

Nov 28, 2006·Endocrinology and Metabolism Clinics of North America·Philipp Schuetz, Beat Müller
Sep 26, 2008·Nursing in Critical Care·Elizabeth D E PapathanassoglouMargarita D Giannakopoulou
Apr 4, 2017·International Journal of Molecular Sciences·Giovanni MistralettiGaetano Iapichino
Jan 10, 2009·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Sunit C Singhi, M Jayashree
Sep 22, 2007·Critical Care Medicine·Gianni BioloMarcello De Cicco
Jun 13, 2009·Inhalation Toxicology·Alan P Farwell, Jack L Leonard

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