Abstract
Sepsis is defined as “life-threatening organ dysfunction caused by a dysregulated host response to infection”. Contrary to the older definitions, the current one not only focuses on inflammation, but points to systemic disturbances in homeostasis, including metabolism. Sepsis leads to sepsis-induced dysfunction and mitochondrial damage, which is suggested as a major cause of cell metabolism disorders in these patients. The changes affect the metabolism of all macronutrients. The metabolism of all macronutrients is altered. A characteristic change in carbohydrate metabolism is the intensification of glycolysis, which in combination with the failure of entering pyruvate to the tricarboxylic acid cycle increases the formation of lactate. Sepsis also affects lipid metabolism—lipolysis in adipose tissue is upregulated, which leads to an increase in the level of fatty acids and triglycerides in the blood. At the same time, their use is disturbed, which may result in the accumulation of lipids and their toxic metabolites. Changes in the metabolism of ketone bodies and amino acids have also been described. Metabolic disorders in sepsis are an important area of research, both for their potential role as a target for future therapies (metabolic resuscitation) and for optimizing the current treatment, such as clinical nutrition.
Highlights
In an experimental sepsis model, significant reductions in hepatic lactate-based gluconeogenesis have been reported (Figure 3B) [92]. This may be related to the impairment of the shuttle systems across the inner mitochondrial membrane in sepsis, which play an important role in this process by transporting protons from lactate oxidation to the mitochondria [93,94]
Ketone bodies are involved in pathways that protect against high concentrations of reactive oxygen species (ROS) [103]
As stated by Singer et al, a more sophisticated understanding of the sequence, dynamics and interaction between the metabolic, hormonal and immunological changes occurring would provide a logical basis for patient-tailored therapeutic interventions [17]
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Contrary to the older definitions, the current one focuses on inflammation, but points to systemic disturbances in homeostasis, including metabolism. The term “metabolism” is defined as the totality of an organism’s chemical reactions. It consists of anabolic and catabolic processes that are physiologically in balance. The current therapy of patients with sepsis consists mainly in antimicrobial treatment and supporting the functions of failing organs. Due to the fact that an innovative approach to the treatment of sepsis constitutes a great unmet need of modern medicine, it seems justified to pay attention to other components of the “dysregulated host response to infection”, which include metabolism, and hemostasis, microbiota, thermoregulation and circadian rhythm [2,3]. Since understanding the role and place of metabolic disorders in the pathophysioslogy of sepsis can allow better management of treatment in sepsis patients, as well as find targets for potential new therapies, the aim of this review is to analyze current knowledge on sepsis metabolic disorders
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
