Current concepts in the metabolic responses to injury, infection and starvation.

The disruption of homoeostatic regulatory mechanisms by injury is well recognized. Survival depends upon a coordinated response by cardiovascular, renal, haematological, respiratory, neural and endocrine systems designed to provide continuing oxygen and nutrients to the cells of vital organs (Moore, 1977). This review is concerned with the biochemical and endocrine adaptation which occurs during the recovery period after injury to provide, in addition to the foregoing, materials for cellular and wound repair, materials for synthesis of immune and other proteins, and the necessary precursors for the long-term supply of metabolic energy. Starvation and infection, and their influence on the postinjury state are also considered.