The burned patient's response to the environment: the 1991 Everett Idris Evans Memorial Lecture. 1991

H B Stoner
North Western Injury Research Centre, Manchester University, England, United Kingdom.

Homeostatic reflexes are believed to supply the means by which the body adapts to changes in the environment (posture, temperature, etc.) and, hence, it might be expected that their importance would increase when the body is disturbed by trauma. In fact, these reflexes are largely abandoned in the response to danger (the defense-arousal reaction), and it is only after simple fluid loss that a limited improvement is seen, that is, an increase in the sensitivity of the baroreflex. Whenever tissue damage generates nociceptive C fiber afferent impulses, there is serious and relatively long-lasting inhibition of the baroreflex and of all aspects of neural thermoregulation. Significant changes occur after quite moderate injuries and do not depend on any reduction in tissue oxygenation. In children with burns in whom early pyrexia is common, central thermoregulation may also be affected by cytokine pyrogens. These changes have implications for the management of patients with all types of injuries. However, further analysis is needed if we are to understand these responses and their role in the body's defense; without this knowledge, we shall not be able to modulate them effectively.

UI MeSH Term Description Entries
D009619 Nociceptors Peripheral AFFERENT NEURONS which are sensitive to injuries or pain, usually caused by extreme thermal exposures, mechanical forces, or other noxious stimuli. Their cell bodies reside in the DORSAL ROOT GANGLIA. Their peripheral terminals (NERVE ENDINGS) innervate target tissues and transduce noxious stimuli via axons to the CENTRAL NERVOUS SYSTEM. Pain Receptors,Receptors, Pain,Nociceptive Neurons,Neuron, Nociceptive,Neurons, Nociceptive,Nociceptive Neuron,Nociceptor,Pain Receptor
D010101 Oxygen Consumption The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346) Consumption, Oxygen,Consumptions, Oxygen,Oxygen Consumptions
D001833 Body Temperature Regulation The processes of heating and cooling that an organism uses to control its temperature. Heat Loss,Thermoregulation,Regulation, Body Temperature,Temperature Regulation, Body,Body Temperature Regulations,Heat Losses,Loss, Heat,Losses, Heat,Regulations, Body Temperature,Temperature Regulations, Body,Thermoregulations
D002056 Burns Injuries to tissues caused by contact with heat, steam, chemicals (BURNS, CHEMICAL), electricity (BURNS, ELECTRIC), or the like. Burn
D003681 Dehydration The condition that results from excessive loss of water from a living organism. Water Stress,Stress, Water
D006706 Homeostasis The processes whereby the internal environment of an organism tends to remain balanced and stable. Autoregulation
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D014883 Water-Electrolyte Imbalance Disturbances in the body's WATER-ELECTROLYTE BALANCE. Imbalance, Water-Electrolyte,Imbalances, Water-Electrolyte,Water Electrolyte Imbalance,Water-Electrolyte Imbalances
D016207 Cytokines Non-antibody proteins secreted by inflammatory leukocytes and some non-leukocytic cells, that act as intercellular mediators. They differ from classical hormones in that they are produced by a number of tissue or cell types rather than by specialized glands. They generally act locally in a paracrine or autocrine rather than endocrine manner. Cytokine

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