Metabolism during critical illness
Critical illness often results in altered cellular energy metabolism
(Fink 2001; Joffe 2001; Mizock 1984; Protti 2006). Although
the mechanisms and exact alterations are poorly understood, it
is clear that protein catabolism and mitochondrial dysfunctions
with metabolic suppression can occur (Joffe 2001;Mizock 1984).
The suggestion that an increased metabolic rate occurs in adults
with critical illness has been questioned (Miles 2006). Similarly,
themetabolic ratemeasured in children with critical illness ismost
often at or belowthe predicted basalmetabolic rate in the firstweek
of illness (Avitzur 2003; Briassoulis 2000; Framson 2007; Jacsik
2001; Letton 1995; Martinez 2004; Oosterveld 2006; White
2000); anabolism (with growth) does not occur (Chwals 1994).