Abstract
Purpose of Review The dictum of surgical metabolism describing the ebb and flow of nutrients after injury can be seen as an alteration of the hormonal milieu. Shock, therefore, is a state by which nutrients are delivered only by diffusion, while shock resolution is marked by a transition to nutrient diversion into essential and salvage pathways. The gut requires significant cardiac output at rest, and this demand increases during enteral feeding. The mismatch between supply and demand can be exacerbated during the shock state, or, paradoxically, improved.
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