Metabolic response to injury

Objective: To outline the modern understanding of the aetiology of the meta bolic response to injury. Data resources: Review of the relevant literature of the twentieth century. Study selection: Papers were selected for their relevance to the topic. Pre ference was for relevant animal and human studies. Data extraction and synthesis: Relevant papers were obtained through MEDLIN E search strategies. Papers were read and analysed for accuracy of methodol ogy, statistics, and application to the review in hand. The review also rel ied heavily on the author's own work. Conclusion: Cytokines are central to the metabolic response to injury and t hat understanding of their compartmentalisation in critical illness could l ead to new therapeutic strategies. The complexity of the system is recognis ed and suggestions are made for the practising surgeon.