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British Medical Bulletin 41:240-245 (1985)
© 1985 The British Council

research-article

SUBCELLULAR ASPECTS OF THE RESPONSE TO TRAUMA

Dennis F Heath

MRC Trauma Unit University of Manchester

Abstract

The following propositions are discussed. 1. Development of permanent membrane damage in vivo depends upon reduction of whole-body oxygen consumption(FormulaO2) to below ‘basal’. In man this rarely occurs until several hours after injury. 2. While FormulaO2 is maintained, effects are neural and hormonal in origin. 3. One cannot predict the feffects of injury in vivo from subcellular mechanisms; the interactions with physiological factors are too complex. 4. Observations on animal models in which FormulaO2 is low often fail to match those on patients, unlike those on models with at least basal FormulaO2. 5. There appear to be at least two types of insulin resistance, one essentially hormonalin origin, the other, more persistent, involving membrane changes that can be studied in vitro.


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