Background: Severe injury is associated with a complex sequence of metabolic events. The accurate quantification of these changes and a developing understanding of their aetiology has been the product of much work by researchers over the past 60 years. An understanding of these phenomena is vital to the practising surgeon because of the plethora of new metabolic modulators threatening to become part of clinical practice.
Methods: This review describes the clinical picture of the metabolic response to severe injury and then outlines modern understanding of the underlying processes.
Results and conclusion: The need for further research before introduction of new technologies is emphasized.