The metabolic response to stress have been selected as an adaptive response to survive critical illness. Several mechanisms well preserved over the evolution, including the stimulation of the sympathetic nervous system, the release of pituitary hormones, a peripheral resistance to the effects of these and other anabolic factors are triggered to increase the provision of energy substrates to the vital tissues. After an acute insult, alternative substrates are used as a result of the loss of control of energy substrate utilization. The clinical consequences of the metabolic response to stress include sequential changes in energy expenditure, stress hyperglycemia, changes in body composition, psychological and behavioral problems. The loss of muscle proteins and function is a major long-term consequence of stress metabolism. Specifi c therapeutic interventions, including hormone supplementation, enhanced protein intake and early mobilization are investigated.,
Department of Intensive Care

Preiser, J.-C., Ichai, C., & Groeneveld, J. (2016). Successive phases of the metabolic response to stress. In The Stress Response of Critical Illness: Metabolic and Hormonal Aspects (pp. 5–18). doi:10.1007/978-3-319-27687-8_2