Starvation as an adaptive response by Harris
-
Upload
oliver-flower -
Category
Documents
-
view
635 -
download
4
Transcript of Starvation as an adaptive response by Harris
Starvation is an adaptive response
Evolution - Adaptation & Critical Illness
‘Starvation is an adaptive response’
Challenge
Should we always feed early?
Through their Eyes
Survival of the fittest
Evolution and critical care?
I’m not hungry – I feel sick
• Stress response & anorexia
Mother knows best
Wear a jumper you’ll
catch cold
Starve a fever feed a cold
Sitting on cold concrete causes piles
• But is anorexia a good thing?
Digestion is Catabolic
Anorexia stimulates Autophagy
Auto-phagy
Macro-Autophagy
43 Days & 1 Mars Bar
EPaNIC v Early PN
EPaNIC
Early PN
Through their Eyes
‘Starvation results in death’
What Do I Do?
We should tailor how we feed
‘Anorexia is an adaptive response’
References1: Signals generating anorexia in acute illness. Langhans W. Proceedings of
Nutrition society 2007;66:321-330
2: Leptin in Anorexia and Cachexia syndrome. Engineer D, Garcia J. International Journal of Peptides 2012;287457:13
3: Autophagy and Adaptive Immunity. Crotzer V, Blum J. Immunology 2010;131:9-17
4: Early versus late Parenteral Nutrition in critically ill Adults. Caesar M et al. N Engl J Med 2011;365:506-17
5: Early Parenteral Nutrition in Critically Ill Patients with short-term relative contraindications to Early Enteral Nutrition. Doig G et al. JAMA 2013;309(20):2130-2138