ABSTRACT
The organic response to stress-rst described as the metabolic response to trauma, in 1942, by Sir David Cuthbertson-is a physiologic phenomenon secondary to any insult to the body. Cuthbertson [1] introduced the terms ebb and flow to describe the phases of hypo-and hypermetabolism that follow traumatic injury. Such phenomenon is triggered by multiple stimuli, including arterial and venous pressure derangements, changes in volume, osmolality, pH, and arterial oxygen content. Also, pain, anxiety, and toxic mediators from tissue injury and infection trigger the organic response (Table 1.1). These stimuli reach the hypothalamus stimulating the sympathetic nervous system and the adrenal medulla. This physiological response to an insult might become pathological depending on the intensity and duration of injury. The organic response can be seen as the fight or flight response to adverse phenomena that can become highly associated with increased morbidity and mortality if perpetuated for long periods. The ultimate goal of the organic response is to restore homeostasis. Intermediate goals are to limit further blood loss; to increase blood ow, allowing greater delivery of nutrients and elimination of waste products; and to debride necrotic tissue and to initiate wound healing.
