Alterations in exogenous substrate metabolism in sepsis
R. C. Fried, P. M. Bailey, J. L. Mullen, T. P. Stein, L. O. Crosby and G. P. Buzby
Metabolic rates and substrate utilization patterns were evaluated by using
a rate cecal ligation and perforation model. Animals that survived for 48
hours after the induction of sepsis were hypermetabolic and responded
appropriately to varying exogenous substrate infusions. In contrast,
animals that did not survive to 48 hours were premorbidly hypometabolic and
failed to adjust their oxidation patterns in response to the exogenous
substrate supply. These findings suggest the benefit of individually
tailoring the supply of exogenous nutrients in critically ill patients with
sepsis and of frequent reassessment of metabolic parameters, including the
resting energy expenditure and respiratory quotient.
