Proteins-Summary & Basic information 1
Protein is the most important nutrient because it is required for all body building functions. The utilization of protein as a source of energy is physiologically wasteful.
Amino acids are utilized in three major ways by the body:
1) Protein synthesis
2) Catabolic reactions leading to either urea or carbon dioxide, and
3) Synthesis of nonessential amino acids and other small molecules
Essential amino acids have a carbon skeleton that cannot be synthesized by the body, but requires an external source, i.e. valine, Lucien, isoleucine, lysine, methionine, phenylalanine, threonine, and tryptophan.
Thus, in critical illness, the majority of amino acids are either essential or conditionally indispensable.
Muscle stores of amino acid
Skeletal muscle contains most of the amino acids in the body.
Glutamate comprises 50% to 60% of all white fast-twitch and mixed muscles.
Within 20 hours of an operative procedure or trauma, a large portion of the glutamate store has been depleted.
The importance, of this phenomenon of rapid depletion, followed by slow refilling of glutamate stores is unclear at this time.
Some success has been achieved in preventing glutamate depletion by using glutamate supplementation.
Protein synthesis is modulated by insulin, amino acid supplementation, branched-chain amino acid concentration, and likely human growth hormone, somatomedin, and insulin-like growth factor.
Normally 60% to 100% of daily nitrogen retention is due to the postprandial branched chain amino acid uptake into skeletal muscle.
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Wednesday, November 24, 2010
Wednesday, November 17, 2010
LIVER IN METABOLIC RESPONSE
LIVER AND ENERGY SOURCES
2. The Role of LIVER
-The liver is the main handler of all nutrients in our body.
-It extracts 75-100% of all portal vein nutrients in one pass.
-Insulin and glucagons are required for liver function.
-Liver and kidney, both play a role in converting excess nitrogen, ( amino acids) into urea.
-Liver can also use amino acids to form glucose.
3. ENERGY SOURCES
3.1 PROTEINS
In a 70 kg man there is 10-11 kg. of protein.
The daily turnover is 250-300 gm mostly in the form of lost cells from GIT and the enzymes in the secretion of the gut.
Most of these amino acids are re-absorbed, about 1 gm is lost in the stools.
Thus 250 gms are sourced from endogenous protein reserve.
If adequate calorie source is provided (fats, carbohydrates) the required proteins will be re-synthesized using these sources of energy.
Dietary intake of small amount (100 gm) of essential and non-
essential amino-acid containing proteins is required to meet body
requirements.
Proteins are an important nutrient.
It is the resource for the amino acid pool for functional activity of the body through enzymes, contraction of muscles, and immune products. However, it is an uneconomic source of energy, since only one fourth is released on breakdown, compared to three times of this ammount of energy used, in synthesis of new proteins required.
There is also a loss of function with loss of muscle mass.
The end use of absorbed amino acids derived from food
proteins are :
* Synthesis of required proteins
-Plasma proteins 20 gm.
-Hb 8gms,
-WBC and skin 20gms
-Muscle 50 gms
* Catabolism leading to urea (80 gm. urea)
* Production of pyrimidines and purines
Any questios be sent to drmmkapur@gmail.com
All earlier posts are stored in archives for access and review.
Visitors to this site may contribute posts provided they follow.
2. The Role of LIVER
-The liver is the main handler of all nutrients in our body.
-It extracts 75-100% of all portal vein nutrients in one pass.
-Insulin and glucagons are required for liver function.
-Liver and kidney, both play a role in converting excess nitrogen, ( amino acids) into urea.
-Liver can also use amino acids to form glucose.
3. ENERGY SOURCES
3.1 PROTEINS
In a 70 kg man there is 10-11 kg. of protein.
The daily turnover is 250-300 gm mostly in the form of lost cells from GIT and the enzymes in the secretion of the gut.
Most of these amino acids are re-absorbed, about 1 gm is lost in the stools.
Thus 250 gms are sourced from endogenous protein reserve.
If adequate calorie source is provided (fats, carbohydrates) the required proteins will be re-synthesized using these sources of energy.
Dietary intake of small amount (100 gm) of essential and non-
essential amino-acid containing proteins is required to meet body
requirements.
Proteins are an important nutrient.
It is the resource for the amino acid pool for functional activity of the body through enzymes, contraction of muscles, and immune products. However, it is an uneconomic source of energy, since only one fourth is released on breakdown, compared to three times of this ammount of energy used, in synthesis of new proteins required.
There is also a loss of function with loss of muscle mass.
The end use of absorbed amino acids derived from food
proteins are :
* Synthesis of required proteins
-Plasma proteins 20 gm.
-Hb 8gms,
-WBC and skin 20gms
-Muscle 50 gms
* Catabolism leading to urea (80 gm. urea)
* Production of pyrimidines and purines
Any questios be sent to drmmkapur@gmail.com
All earlier posts are stored in archives for access and review.
Visitors to this site may contribute posts provided they follow.
Wednesday, November 10, 2010
BODY METABOLIC RESPONSE
The Phases of Metabolic Response
1.3 The early phase is also known as Low Flow Phase (Ebb phase) and it occurs immediately after the injury and lasts for 24 hours.
We see a fall in metabolic functions, decrease in body temperature and increase in the levels of stress hormones cortisol,
Epinephrine,
And aldosterone.
1.4 This phase is followed by a Flow phase where the body temperature
and metabolic function rises
There is an increased insulin level, glucose and blood lactate.
With the efficient resuscitative measures the second phase (flow phase) can be brought in earlier.
This is the hyper-metabolic phase and is manifested by an upward
shift in temperature control centre and is a part of the response
to trauma.
Individuals vary in their response to trauma; two important factors are severity of trauma,
And nutritional status of the patient.
Infection also prolongs this phase.
This is the catabolic phase (break down) this phase is because of hypo-volume (loss of blood or fluid) seen in trauma and reduced tissue perfusion, and tends to conserve the bodies resources.
1.5 Anabolic phase.
This is the phase that follows the first two phases and is the phase of rebuilding of the loss resulting from the injury.
This is also called convalescence.
The patient feels better and puts on weight in well treated patients. It starts from 2nd to 10 day onwards.
The hormones required in this phase are insulin and growth
hormone.
Any question be sent to drmmkapur@gmail.com
All earlier posts are stored in archives for access and review
Those visitors that follow the blog may post contributions
1.3 The early phase is also known as Low Flow Phase (Ebb phase) and it occurs immediately after the injury and lasts for 24 hours.
We see a fall in metabolic functions, decrease in body temperature and increase in the levels of stress hormones cortisol,
Epinephrine,
And aldosterone.
1.4 This phase is followed by a Flow phase where the body temperature
and metabolic function rises
There is an increased insulin level, glucose and blood lactate.
With the efficient resuscitative measures the second phase (flow phase) can be brought in earlier.
This is the hyper-metabolic phase and is manifested by an upward
shift in temperature control centre and is a part of the response
to trauma.
Individuals vary in their response to trauma; two important factors are severity of trauma,
And nutritional status of the patient.
Infection also prolongs this phase.
This is the catabolic phase (break down) this phase is because of hypo-volume (loss of blood or fluid) seen in trauma and reduced tissue perfusion, and tends to conserve the bodies resources.
1.5 Anabolic phase.
This is the phase that follows the first two phases and is the phase of rebuilding of the loss resulting from the injury.
This is also called convalescence.
The patient feels better and puts on weight in well treated patients. It starts from 2nd to 10 day onwards.
The hormones required in this phase are insulin and growth
hormone.
Any question be sent to drmmkapur@gmail.com
All earlier posts are stored in archives for access and review
Those visitors that follow the blog may post contributions
Wednesday, November 3, 2010
THE EFFECTS OF SURGERY
METABOLISM AND NUTRITIONAL CONSIDERATIONS IN SURGICAL PATIENTS
1. METABOLISM
1.1 Surgical disorders, and surgical interventions, alter the
Internal environment of the patients, and the significant factors are :
* Nutritional deficiency due to the disorder, or the post-operative
starvation
* Metabolic effects of surgical intervention trauma, during, and after the procedure
* Metabolic effects, of physical trauma, in injuries and accidents
* Metabolic effects on cells, and tissues, due to bacterial
invasions in inflammatory disorders
* Tumour burden effects, of uncontroled cell multiplication, and spread
in cancer patients
The main stimulus, responsible for endocrine response, is pain, from the site of
Injury, or disease up along the spino-thalamic tract.
These messages are received in the brain stem, thalamus, and cortex.
The centers in the hypothalamus activate the sympathetic
nervous system and the pituitary. This results in raising serum
levels of :
* Cortisol
* Epinephrine
* Nor-epinephrine
* Aldersterone
* ADH
* Glucagons
1.2 A controlled injury received in surgical interventions is limited.
In cases of trauma, the factors of extent, and severity of injury are
Are variable, the injury occurs outside the hospital, and in many instances severity of injury can only be calculated, from the number of limbs, organs and
body cavities involved.
It has been noted that, the metabolic response, and endocrine response are related to the severity of the injury and in many instances these response may be many times more than the responce caused by a planned surgical interventions.
Any questions be sent to drmmkapur@gmail.com
All earlier posts are stored in archives for access and review
If you follow the blog you may contribute to the posts
1. METABOLISM
1.1 Surgical disorders, and surgical interventions, alter the
Internal environment of the patients, and the significant factors are :
* Nutritional deficiency due to the disorder, or the post-operative
starvation
* Metabolic effects of surgical intervention trauma, during, and after the procedure
* Metabolic effects, of physical trauma, in injuries and accidents
* Metabolic effects on cells, and tissues, due to bacterial
invasions in inflammatory disorders
* Tumour burden effects, of uncontroled cell multiplication, and spread
in cancer patients
The main stimulus, responsible for endocrine response, is pain, from the site of
Injury, or disease up along the spino-thalamic tract.
These messages are received in the brain stem, thalamus, and cortex.
The centers in the hypothalamus activate the sympathetic
nervous system and the pituitary. This results in raising serum
levels of :
* Cortisol
* Epinephrine
* Nor-epinephrine
* Aldersterone
* ADH
* Glucagons
1.2 A controlled injury received in surgical interventions is limited.
In cases of trauma, the factors of extent, and severity of injury are
Are variable, the injury occurs outside the hospital, and in many instances severity of injury can only be calculated, from the number of limbs, organs and
body cavities involved.
It has been noted that, the metabolic response, and endocrine response are related to the severity of the injury and in many instances these response may be many times more than the responce caused by a planned surgical interventions.
Any questions be sent to drmmkapur@gmail.com
All earlier posts are stored in archives for access and review
If you follow the blog you may contribute to the posts
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