Impact of metabolic interventions on the endocrine system of the critically ill.

Critically ill patients can only survive through intensive medical care, but patients who need intensive care for more than 5 days have still a high risk of death. The metabolic changes during prolonged critical illness are associated with a uniform dysregulation of all hypothalamicanterior-pituitary axes, long known to contribute to the high risk of morbidity and mortality. Extensive research, predominantly by our lab, has provided more insight in the biphasic neuro-endocrine response to critical illness. It is becoming increasingly apparent that adipose tissue is a major endocrine organ in the body that plays a crucial role in energy homeostasis not only in storing triglycerides, but also in responding to nutrient and hormonal signals. A disturbed regulation of the storage process and/or endocrine actions will lead to organism-wide changes in insulin sensitivity. In this project we try to examine the impact of critical illness and the possible role of metabolic interventions on the adipose tissue as a storage and as an endocrine organ, neuro-endocrine interactions with the adipose tissue and the the underlying fuel sensing mechanism.

Keywords:Critical Illness, Endocrinology

Disciplines:Anaesthesiology, Intensive care and emergency medicine, Endocrinology and metabolic diseases