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Probably the most striking, and yet least understood, response to injury in the previously healthy patient is the immediate, massive secretion of adrenal cortical hormones, primarily the 17-hydroxycorticoids. The complex nature of the action of these endocrine substances apparently involves their ability to mobilize cellular energy for work and act in the injured patient to achieve homeostasis at a new metabolic level. Under their influence, vasopressors are potentiated; sodium and body water are retained; muscles can function anerobically; gluconeogenesis occurs, and capillary resistance is increased. Further effects, such as their euphoric, antiendotoxic, and antipyretic action, also are thought to demonstrate the ability of these hormones to prepare the body better to withstand severe trauma. In the normal person the onset of increased adrenal activity is marked by the sudden eosinopenia which commences with the injury and which should reach near-zero levels within two to three hours, returning to normal or
HOAGLAND PW. Hormonal and Metabolic Response to Injury. AMA Arch Surg. 1957;75(5):704–705. doi:10.1001/archsurg.1957.01280170014005
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