Catabolic illness. Strategies for enhancing recovery

N Engl J Med. 1991 Sep 5;325(10):695-702. doi: 10.1056/NEJM199109053251005.


After injury, infection, extensive chemotherapy, and other critical illnesses, both protein and fat are lost from the body. Although minor alterations in body composition are probably of little clinical importance, losses of body protein of 10 percent or more contribute to morbidity and debility. This catabolic response can be modified and recovery can be accelerated by a variety of approaches. First, the inflammatory response can be reduced; second, specific nutrients can be provided to support the patient's tissue requirements during catabolic illness; and third, growth factors can be used to enhance protein synthesis and tissue repair. These approaches, whether used alone or in combination, will reduce the loss of body protein, which should accelerate recovery, shorten the length of hospitalization, and reduce convalescence.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Adipose Tissue / metabolism*
  • Cachexia / metabolism
  • Cachexia / therapy
  • Critical Care*
  • Energy Intake
  • Growth Substances / administration & dosage
  • Humans
  • Metabolic Diseases / etiology
  • Metabolic Diseases / physiopathology
  • Metabolic Diseases / therapy
  • Muscles / metabolism*
  • Parenteral Nutrition, Total*
  • Proteins / metabolism*
  • Stress, Physiological / metabolism
  • Stress, Physiological / therapy
  • Weight Loss


  • Growth Substances
  • Proteins