Therapeutic approach to the hepatosplanchnic area during trauma and sepsis- Beyond O-2-supply/O-2-uptake relationship?

Citation
K. Trager et al., Therapeutic approach to the hepatosplanchnic area during trauma and sepsis- Beyond O-2-supply/O-2-uptake relationship?, ANAESTHESIS, 49(5), 2000, pp. 451-454
Citations number
28
Language
TEDESCO
art.tipo
Article
Categorie Soggetti
Aneshtesia & Intensive Care
Journal title
ANAESTHESIST
ISSN journal
0003-2417 → ACNP
Volume
49
Issue
5
Year of publication
2000
Pages
451 - 454
Database
ISI
SICI code
0003-2417(200005)49:5<451:TATTHA>2.0.ZU;2-A
Abstract
Sepsis and SIRS are characterised by increased hepatosplanchnic blood flow and oxygen transport due to sepsis-associated hypermetabolism with enhanced oxygen uptake. Regional hypermetabolism may be linked with a mismatch of o xygen availability and demand potentially resulting in a pathological splan chnic oxygen uptake/supply dependency. Splanchnic hypermetabolism has been hypothesised to be due to increased hepatic gluconeogenesis caused by accel erated glucose precursor uptake resulting from increased release from the p eripheral tissues. This increased precursor efflux is triggered by cytokine s. The response of splanchnic haemodynamics and oxygen kinetics, however, t o therapeutic interventions does not necessarily parallel the different met abolic pathways. Therefore, understanding of both tissue perfusion and oxyg enation as well as metabolism is pivotal for evaluating the effects of diff erent therapeutic strategies in intensive care medicine.