Changes of metabolism in surgical critically ill patients and the significance for clinical nutrition     CAI Chang-jie. SICU, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
Abstract    In recent years, with a better understanding of the surgical critically ill patients’pathophysiology, the timely, effective treatments could give them who have severe trauma and infection. The treatments can significantly shorten the course of the disease and improve the prognosis. In the process, nutritional support is an important content. Due to an activation of HPA axis and a variety of inflammatory mediators, serious impact will occur to the metabolism of the main nutrients, such as: sugar, fat, protein and so on. Understanding of the pathophysiology alteration mechanism of the nutrients, it will better guide surgeons to perform rational nutritional support.