ABSTRACT
The metabolic response to injury is a physiological ‘systemic inflammatory’ reaction to tissue damage. It is a hormone-mediated defence response that establishes the optimum environment for wound control, debridement and subsequent repair. In some circumstances it may become prolonged or exaggerated. If control is lost, this may lead to a pathological systemic inflammatory response known ‘host defence failure disease’ or ‘multi-organ failure’. This accounts for the third peak of the ATLS trimodal distribution of death following major trauma.
