Metabolic derangements in sepsis and septic shock.

This article examines the spectrum of metabolic alterations in sepsis and septic shock. The clinical manifestations, neuroendocrine control, and bioenergetics of the "ebb" and "flow" phases of sepsis are reviewed. Characteristic alterations in carbohydrate, fat, and protein metabolism induced by sepsis are outlined. Finally, the implications of these metabolic alterations for the nutritional support of patients with sepsis are discussed.