Metabolic and Inflammatory Responses to Trauma

Although one can thought that the processes of metabolism with relatively simple and familiar equations involving the "burning“ of sugar or fat to produce adenosine triphosphate (ATP), the causes of metabolic dysfunction go beyond biochemical reactions, and are complex at both the cellular and organ and system levels.

Mitochondria are commonly referred to as the "powerhouse of the cell."
The power is distributed via the high-energy phosphate bonds of ATP.
ATP is thus a safe and stable fuel, which contains a large amount of energy that may be used to facilitate a wide variety of biologic processes

The conversion of substrates (glucose, ketones, fatty acids, lactate, etc ) to ATP is accomplished via a highly efficient process that uses oxygen.
For example, oxidation in the Krebs citric acid cycle of one molecule of glucose has the potential to yield )30 molecules of ATP.

Trauma and infection initiate changes in metabolism that can affect virtually all organs and tissues, by altering carbohydrate, lipid, and protein metabolism.
The metabolic response to injury and sepsis has traditionally been divided into an ebb phase and a flow phase followed by convalescence phase.

The ebb phase is dominated by glycogenolysis and Lipolysis,which provides the organism with energy substrates for "fight or flight" responses.
This is followed by the flow phase, a state of catabolism manifested by elevated metabolic rate and increases in body temperature, pulse rate, urinary nitrogen excretion, and muscle catabolism.
The subsequent anabolic "recovery“ phase can last from weeks to months.