Abstract
Many metabolic disturbances accompany the evolution of the severe aggression, i.e. critically ill patients. The cytokinic cascade and the neuroendocrine disturbances lead to an increase in the energy expenditure, an important proteinic catabolism, and an insulin resistance of peripheral tissues. The mechanisms and the consequences of these metabolic anomalies are gradually updated, and of the nutritional or pharmaconutritional solutions are now proposed.
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