Please enable JavaScript.
Coggle requires JavaScript to display documents.
Metabolic Surgical Response - Coggle Diagram
Metabolic Surgical Response
Stages of the surgical metabolic response
Ebb phase: metabolic response during surgery
Increased catecholamines and glucagon
Increased blood glucose, lactate, FFA
Decreased CO and below normal core temp
Reduced oxygen consumption
Organ hypoxia and ischaemia
Flow phase: metabolic response after surgery
To increased blood flow to wound to promote wound healing
To increase blood flow to vital organs to maintain function
A state of hypermetabolism
Increased catecholamines, glucagon, and cortisol in blood
Increased CO, pulse, RR, body temp
Increased aldosterone and ADH
Causing fluid retention
Increased cytokines
Systemic inflammatory response
Multi-organ failure
Anabolic phase: recovery from operation
Increased nutrient intake
Loss of retained fluid
Restoration of lean body mass, body weight, fat store, wellbeing
Consequences of trauma and stress
Hypothermia
Vasoconstriction
Decreased CO
Coagulopathy
Tissue trauma
Inflammatory response
Bleeding
Hypotension
Hypoperfusion of vital organs
Blood transfusion
Immunosuppression
Bacterial contamination / dessication of wound
Infection
Exposure of viscera to air
Fluid loss
Hypothermia
Systemic inflammatory response syndrome (SIRS)
Temp > 38 degrees
HR > 90bpm
WBC count > 12*10^9/L
RR > 20/min
Physiology
Leakage of fluid from capillaries to interstitial space
Tissue edema
Reduced nutrient and oxygen supply to cells
Thrombi formation
Ischaemia
Macrophages in organ
Cytokine production
Organ manifestation
Brain: encephalopathy
Nerve: polyneuropathy
Muscle: myopathy of critical illness
Lung: ARDS
Heart: shock, peripheral edema
GI tract: delayed gastric emptying, stress ulcer, paralytic ileus, anorexia
Kidney: acute tubular necrosis
Blood: DIC