4 - Endocrine Aspects of the Metabolic Response to Injury

Abstract

The endocrine system responds to the stimulus of injury by an increased secretion of many hormones, the extent and duration of the response depends upon the severity of the injury and the presence of complications. Alteration in the rate of utilization and excretion of hormones after injury affects the amounts which can be measured in blood and urine. The relationship between the metabolic and endocrine response is a complex one. This chapter discusses the endocrine aspects of the metabolic response to injury. The controller of the endocrine system increases its production of hormones from both portions of the gland after injury. The anterior pituitary liberates adrenocorticotrophic hormone (ACTH) and growth hormone and the posterior pituitary produces anti-diuretic hormone. ACTH levels elevate in the blood immediately before and after elective operations, but normal levels are restored within a few hours. Most anterior pituitary hormones are secreted in response to a negative feedback mechanism where increases in the secretion of hormones by the target glands inhibit the further secretion of the appropriate trophic hormone by the anterior pituitary.