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* Hypermetabolism: an increase in
Energy Utilization
*
Severe Catabolism: rapid erosion of Lean Mass,
critical to body structure and
function |
The
metabolic abnormalities will be discussed first
beginning with the fundamentals, then expand the
knowledge base.
The
first fundamental problem is a persistent
increase in body metabolism or hypermetabolism
which increases energy utilization thereby increasing
energy demand.
The
second problem is severe catabolism or
tissue breakdown and protein degradation. The lean
body mass compartment contains the body protein is
eroded which means loss of muscle, visceral protein,
collagen and proteins required for organ structure and
cell function.
Metabolism and
Burn Injury (Key Definitions)
ENERGY: CAPACITY
TO DO WORK
ENERGY
PRODUCTION: defined in terms of standard
ENERGY
units produced per time, or OXYGEN CONSUMED per time as
O2 is used
to make ENERGY
ENERGY
CONSUMPTION - energy used/time
(e.g.. Kcal/hr or ml O2/min)
KILOCALORIE - standard measure of the quantity
of ENERGY
obtained from nutrients (often referred to as a
Calorie) (e.g. One
gram Carbohydrate produces 3.3 Kcal)
KEY
DEFINITIONS
In order
to proceed further we need to understand the terminology
used in describing metabolism. The term energy simply
means the capacity to do work. In terms of the body any
activity or cell function requires work or energy to
perform.
Energy production is a term used to quantify the amount of
energy generated over time. Since 95% of the oxygen used
is for energy production, oxygen consumed can also be
used as a measure of energy as can the Kilocalorie
(Calorie).
Energy consumed again
quantifies the energy used. Energy consumed, in the form
of oxygen used or Calories burned is used to determine
the patients nutrient
requirements.
A Kilocalorie is the
measure of energy used to describe the available energy
in specific nutrients when metabolized. Different
nutrients contain different quantities of
potential energy. When
discussing calories, required in nutritional support,
one is still dealing with the fundamental concept of
energy.
Calorie is a
term used interchangeably with Kcal.
Key
Definitions
METABOLISM: Sum (body) total of all chemical reactions
required for cell function - an energy requiring process
METABOLIC RATE: rate of metabolic activity defined in terms of
energy consumed per time (e.g. Kcal/hr)
BASAL METABOLIC RATE: amount of ENERGY expended at
complete rest (available in standard charts) age, sex,
size dependent
HYPERMETABOLISM: increase in metabolic rate
above normal for a specific activity
level
ANABOLISM: Constructive Metabolism: new tissue formation
with protein synthesis.
CATABOLISM: Destructive Metabolism: tissue degradation with
protein breakdown
  
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