Fat Alterations in Injury,

The influence of injury on fat metabolism is a dramatic example of how surgeons had depended upon the wisdom of the body to regulate whatever alterations are needed without causing abnormal concentration of lipid material in either the plasma or in various tissues and organs. The importance of this subject begins with the long recognition by pathologists that patients who die after a stormy convalescense from injury or infection are often found to have abnormal depositions of fat in the liver, lungs, and occasionally in other tissues, such as myocardium and kidney. This aroused speculation that fat utilization for fuel might be greatly reduced in these conditions, perhaps because protein breakdown was providing a much higher proportion of tissue fuel. This presentation is directed toward the influence of injury and infection on endogenous fat metabolism and also the influence of parenteral carbohydrate and parenteral lipid on fat metabolism during these conditions.