Metabolic response in severely traumatized patients.

Acute severe trauma induces alterations in glucose, protein and fat metabolism through neurohormonal mechanisms. This study investigated the temporal relationship between serum cortisol, insulin levels and metabolic changes in glucose, protein and fat following acute severe trauma. Thirty adult patients admitted with polytrauma were investigated after two to three days of admission compared with thirty normal adults. There were highly significant increases in fasting blood glucose, ketones, triglycerides, cortisol and insulin, and highly significant decreases in total proteins and albumin. The study speculate that post traumatic hyperglycemia, decreased total proteins and albumin are major metabolic changes following severe trauma. These changes were mediated through neurohormonal mechanism included mainly the increased blood cortisol level.