BookKimberly A. Davis, Stanley H. Rosenbaum, editors.
Summary: The goal of this book is not to follow a traditional systems or organ-based approach but rather to encourage our readers to think of the patients as complex biochemical systems. The book provides information that supplements the more traditional approaches and provides a detailed overview of the metabolic knowledge needed for surgical practice. The text reviews normal physiology, the pathophysiology of starvation and surgical stressors. It also focuses on appropriate nutritional repletion for various common disease states. Specifically, chapters address the severe metabolic demands created by systemic inflammation, infection, and major insults such as trauma and burns. All chapters are written by experts in their fields and include the most up-to-date scientific and clinical information. As biochemical aspects of modern medicine are advancing rapidly, chapters have been updated and several new chapters have been added in order to help readers keep pace in this race for state-of-the-art knowledge. Surgical Metabolism: The Metabolic Care of the Surgical Patient 2nd Edition is designed for clinicians across levels of training and provides clear and concise evidence based guidelines for the metabolic management and nutritional support of the surgical patient.
Contents:
Intro
Preface
Contents
Contributors
Abbreviations
Part I: Normal Metabolism
1: Introduction to Metabolism
Introduction
History of Metabolism
The Hierarchy of Metabolism
The Mitochondrial Level
The Cellular Level
The Organ Level
Metabolic States at the Organism Level
Energy Requirements
Normal Energy Requirements
Abnormal Energy Requirements
The Measurement of Energy Requirements
Direct Calorimetry
Indirect Calorimetry
Equations to Calculate REE
Sources of Energy
Carbohydrates
Proteins
Lipids
Alternate Sources of Energy Normal Metabolic Processes
Cofactors and Enzymes
Therapeutic Interventions
Normal Metabolism
Perturbations of Metabolism
Starvation
Obesity
Metabolic Stressors
Genomics Impacting Metabolism
Metabolomics
Inborn Errors in Metabolism
References
2: Fluid and Electrolytes
Introduction
Total Body Water and the Fluid Compartments
Volume Control Mechanisms
Baseline Water and Electrolyte Requirements
Parenteral Solutions
Maintenance Fluid Therapy
Resuscitative Fluid Therapy
The Relationship Between Disorders of Water Balance and Sodium Balance Disorders of Sodium Metabolism
Disorders of Potassium Metabolism
Disorders of Calcium Metabolism
Disorders of Magnesium Metabolism
Disorders of Phosphorous Metabolism
References
3: Acid-Base Physiology
General Principles
Physiologic Basis for Acid-Base Disorders and Their Compensation
Chemical Buffering Systems
Physiologic Determinants of Acid-Base Maintenance
Renal System
Renal Reabsorption of Bicarbonate and Excretion of Acid
Kidney-Liver Interaction
Gastrointestinal Tract
Respiratory Regulation of Carbon Dioxide Description and Classification of Acid-Base Disorders
Assessment of Acid-Base Balance
Metabolic Acid-Base Disorders
Metabolic Acidoses
Pathophysiology
Anion Gap Acidoses
Determination of Anion Gap
Clinical Utility of Anion Gap
Strong Ion Gap
Lactate
Sodium Bicarbonate
Ketoacidosis
Acidosis Secondary to Toxin Ingestion
Salicylates
Alcohols
Ethylene Glycol
Methanol
Isopropyl Alcohol
Renal Failure
Acidosis Secondary to Rhabdomyolysis
Acidosis of Unknown Origin
Prognostic Significance of Positive-AG Metabolic Acidosis Non-anion Gap Acidosis (Hyperchloremic)
Gastrointestinal Tract Loss
Renal Tubular Acidosis
Iatrogenic Acidosis
Unexplained Hyperchloremic Acidosis
Metabolic Alkaloses
Pathogenesis and Differential Diagnosis
Chloride-Sensitive Metabolic Alkaloses
Chloride-Resistant Metabolic Alkaloses
Other Causes of Metabolic Alkalosis
Diagnostic Evaluation and Management
Metabolic Acidosis
Respiratory Acid-Base Disorders
Pathophysiology
Respiratory Acidosis
Mechanism
Management
Treatment of Underlying Ventilatory Impairment
Control of Hypoxemia