This aim of this book is to focus on a very common situation seen in medical practice, the acute catabolic state. This pathophysiological sit­ uation is rarely discussed as a separate entity, possibly because it is seen in all specialties of medicine and results from a great diversity of agents, insults, and diseases. It thus seemed to be high time to gather the most important and up-to-date knowledge on this entity, and the primary aim of the book is to offer a collection of updated information on the acute catabolic state. Another objective of the book is to make clear that, apart from the general response of the whole organism during the acute catabolic state, a series of organ-specific responses will also take place, which must also be considered during treatment. It has become very clear of these organ-spe­ from working on this book that current knowledge cific responses is very sparse and in some areas almost nonexistent; this book thus also focuses on the responses and changes which take place in different organs during the acute catabolic state and the inter­ action between these organs and their responses.

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The Acute Catabolic State: Do We Have to Get Worse to Get Better?.- The History of Metabolic Response to Injury.- Substrate Handling in Stress-Induced Catabolic State - Where is the Challenge?.- The Role of the Nervous System in Modulating the Catabolic State.- The Early Endocrine Response to Injury.- Immunity in the Acute Catabolic State.- Skeletal Muscle in the Stress-Induced Catabolic State.- The Heart and Circulation in the Acute Catabolic State.- Glutamine, the Gut, and the Acute Catabolic State.- Renal Failure in the Acute Catabolic State.- The Liver in the Induction and Regulation of the Acute Stress Response.- The Role of the Pancreas in the Induction of the Acute Catabolic State.- The Lungs and the Catabolic State.- Acute Metabolic Response to Skin Injury Following Burn and the Potential Use of Growth Hormone.- The Endothelium.- Aspects of Bone Tissue in Relation to Catabolic States.- Catabolism and Tumor - Could a General Catabolic Reaction Be Useful in Treatment of Solid Tumors?.- Effect of Neural Blockade in the Acute Catabolic State.- Use of Cyclooxygenase Inhibitors in the Acute Catabolic State.- Cytokines and the Acute Catabolic State.- Antioxidants and the Acute Catabolic State.- Effects of Amino Acid Therapy on Skeletal Muscle in the Acute Catabolic State.- Nutrition in the Acute Catabolic State.- Growth Hormone.- The Growth Hormone/Insulin-Like Growth Factor I Axis During Surgical Stress and Critical Illness.- Therapeutic Recommendations and Future Research.