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Class 19 - Critical Care 2011

Class 19 - Critical Care 2011 - HUN4445 Critical Care...

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HUN4445 Critical Care Objectives Describe the metabolic changes that occur in response to trauma and metabolic stress Discuss the implications of these changes for nutrition assessment Discuss the nutritional management of the trauma patient Critical Care Situations Severe infection (sepsis) Motor vehicle accident (MVA) victims with serious injuries Burn victims Gunshot or stab wounds Multiple injuries from accidents of any sort Initial Response to Trauma Rapid loss of fluid, electrolytes and blood causing hypovolemia Hypovolemia causes decreased perfusion of organs and cells resulting in anoxia, organ ischemia and failure Cells convert to anaerobic glycolysis and lactic acid accumulates Response to Stress Ebb Phase (Hypovolemic Shock) Decreased cardiac output Decreased O 2 consumption Decreased blood pressure Decreased body temperature Decreased insulin:glucagon ratio Flow Phase Response to Stress Secretion of antidiuretic hormone and aldosterone ( Na and H 2 0 retention)
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