Hormonal and metabolic responses to trauma

The stress response is the result of integrated endocrine, metabolic and immune mechanisms which promote tissue healing and restore physiological homeostasis after tissue damage. The two activated and interacting limbs of the response are the hypothalamic-pituitary-adrenal axis and the cytokine cascade. The resultant state is characterized by catabolism (proteolysis, lipolysis and glycogenolysis), production of energy substrates and water and sodium retention with increased sympathetic tone. Together with an activated immune system the body's reserves focus on combating pathogens and tissue repair, whilst maintaining vital organ function.