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      Hipermetabolismo en el paciente quemado Translated title: Hypermetabolism in the burned patient Translated title: Hipermetabolismo nos pacientes queimados

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          Abstract

          Resumen: La lesión por quemadura se denomina con frecuencia la forma más grave de trauma en relación con la elevada respuesta metabólica que genera debido a que puede perpetuarse y permanecer elevada incluso hasta tres años después de que la lesión se ha resuelto. Las alteraciones en el metabolismo son complejas debido a los diversos mecanismos involucrados (hormonales, inflamatorios, metabólicos y genéticos). Existen también en la actualidad diversos mecanismos implementados con la finalidad de tratar de frenar esta respuesta hipermetabólica. La finalidad de este artículo es dar a conocer al personal médico cuáles son las principales causas del hipermetabolismo y las estrategias de manejo que existen en el tratamiento del quemado grave.

          Translated abstract

          Abstract: Burn injury is often referred to as the most severe form of trauma in relation to the high metabolic response it generates because it can be perpetuated and remain elevated even up three years after the injury has resolved. Metabolic alterations are complex due to various mechanisms involved (metabolic, hormonal, inflammatory and genetic). Currently there are several mechanisms implemented in order to try to stop this hypermetabolic response. The purpose of this article is to inform medical personnel, which are the main causes of hypermetabolism and management strategies that exist in the treatment of severe burn.

          Translated abstract

          Resumo: A lesão por queimadura é freqüentemente referida como a forma mais grave de trauma em relação à alta resposta metabólica que gera, pois pode perpetuarse e permanecer elevada até três anos após a resolução da lesão. As alterações do metabolismo são complexas devido aos vários mecanismos envolvidos (hormonais, inflamatórios, metabólicos e genéticos). Existem também atualmente vários mecanismos implementados a fim de tentar parar esta resposta hipermetabólica. O objetivo deste artigo é dar a conhecer à equipe médica, quais são as principais causas do hipermetabolismo e as estratégias de manejo que existem no tratamento de queimaduras graves.

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          Most cited references20

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          THE GLUCOSE FATTY-ACID CYCLE ITS ROLE IN INSULIN SENSITIVITY AND THE METABOLIC DISTURBANCES OF DIABETES MELLITUS

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            The Metabolic Stress Response to Burn Trauma: Current Understanding and Therapies

            Summary Severe burns incur a profound stress response, which is unrivaled in terms of its magnitude and duration. Recent evidence suggests that the pathophysiological stress response to severe burns persists for several years post injury. Thus, there is a pressing need for novel strategies that mitigate this response and restore normal metabolic function in burn survivors. This is the first installment of a three-part series exploring the stress response to severe burn trauma. In this article we aim to distill the current knowledge pertaining to the stress response to burn trauma, highlighting recent developments and important knowledge gaps that need to be pursued in order to develop novel therapeutic strategies which improve outcomes in burn survivors.
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              The ubiquitin proteasome system in atrophying skeletal muscle: roles and regulation.

              Muscle atrophy complicates many diseases as well as aging, and its presence predicts both decreased quality of life and survival. Much work has been conducted to define the molecular mechanisms involved in maintaining protein homeostasis in muscle. To date, the ubiquitin proteasome system (UPS) has been shown to play an important role in mediating muscle wasting. In this review, we have collated the enzymes in the UPS whose roles in muscle wasting have been confirmed through loss-of-function studies. We have integrated information on their mechanisms of action to create a model of how they work together to produce muscle atrophy. These enzymes are involved in promoting myofibrillar disassembly and degradation, activation of autophagy, inhibition of myogenesis as well as in modulating the signaling pathways that control these processes. Many anabolic and catabolic signaling pathways are involved in regulating these UPS genes, but none appear to coordinately regulate a large number of these genes. A number of catabolic signaling pathways appear to instead function by inhibition of the insulin/IGF-I/protein kinase B anabolic pathway. This pathway is a critical determinant of muscle mass, since it can suppress key ubiquitin ligases and autophagy, activate protein synthesis, and promote myogenesis through its downstream mediators such as forkhead box O, mammalian target of rapamycin, and GSK3β, respectively. Although much progress has been made, a more complete inventory of the UPS genes involved in mediating muscle atrophy, their mechanisms of action, and their regulation will be useful for identifying novel therapeutic approaches to this important clinical problem.
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                Author and article information

                Journal
                mccmmc
                Medicina crítica (Colegio Mexicano de Medicina Crítica)
                Med. crít. (Col. Mex. Med. Crít.)
                Colegio Mexicano de Medicina Crítica A.C. (Ciudad de México, Ciudad de México, Mexico )
                2448-8909
                August 2021
                : 35
                : 4
                : 194-199
                Affiliations
                [2] Ciudad de México orgnameHospital General «Dr. Manuel Gea González» orgdiv1Unidad de Cuidados Intensivos Mexico
                [1] Ciudad de México orgnameInstituto Nacional de Rehabilitación, «Luis Guillermo Ibarra Ibarra» orgdiv1Centro Nacional de Investigación y Atención de Quemados Mexico
                Article
                S2448-89092021000400194 S2448-8909(21)03500400194
                5f4cd8cc-9401-44c2-8c1b-97aa8438d033

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 29 January 2020
                : 24 February 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 6
                Product

                SciELO Mexico

                Categories
                Temas de revisión

                paciente queimado,Hipermetabolismo,nutrición,paciente quemado,Hypermetabolism,nutrition,burned patient,nutrição

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