Organ protective mechanisms common to extremes of physiology: a window through hibernation biology. Academic Article uri icon

start page

  • 497

end page

  • 515

abstract

  • Supply and demand relationships govern survival of animals in the wild and are also key determinants of clinical outcomes in critically ill patients. Most animals' survival strategies focus on the supply side of the equation by pursuing territory and resources, but hibernators are able to anticipate declining availability of nutrients by reducing their energetic needs through the seasonal use of torpor, a reversible state of suppressed metabolic demand and decreased body temperature. Similarly, in clinical medicine the majority of therapeutic interventions to care for critically ill or trauma patients remain focused on elevating physiologic supply above critical thresholds by increasing the main determinants of delivery of oxygen to the tissues (cardiac output, perfusion pressure, hemoglobin concentrations, and oxygen saturation), as well as increasing nutritional support, maintaining euthermia, and other general supportive measures. Techniques, such as induced hypothermia and preconditioning, aimed at diminishing a patient's physiologic requirements as a short-term strategy to match reduced supply and to stabilize their condition, are few and underutilized in clinical settings. Consequently, comparative approaches to understand the mechanistic adaptations that suppress metabolic demand and alter metabolic use of fuel as well as the application of concepts gleaned from studies of hibernation, to the care of critically ill and injured patients could create novel opportunities to improve outcomes in intensive care and perioperative medicine.© The Author 2014. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

date/time value

  • September 2014

Digital Object Identifier (DOI)

  • 10.1093/icb/icu047

PubMed Identifier

  • 24848803

volume

  • 54

number

  • 3

keywords

  • Adaptation, Physiological
  • Animals
  • Critical Illness
  • Energy Metabolism
  • Fatty Acids
  • Hibernation
  • Humans
  • Hypothermia, Induced
  • Mammals
  • Outcome Assessment (Health Care)
  • Oxidation-Reduction
  • Oxygen Consumption
  • Sepsis