The neuroendocrine response to multiple trauma

Abstract The neuroendocrine response to multiple trauma is a coordinated, complex, changing response which has as its objective maintenance of life by preserving oxygen delivery and the mobilization and utilization of the synthetic and energetic substrates required by the body. The afferent system is composed of neural input from the various chemoceptors, nociceptors, and baroceptors which monitor normal bodily function, in addition to the effects of plasma factors directly on the brain (e.g., glucose and amino acids). The efferent system is composed of the autonomic nervous system and the output of the anterior and posterior pituitary and other hormones. The efferent response is shown by measurements of ACTH, arginine vasopressin, growth hormone, prolactin, norepinephrineepinephrine, and opiate peptides. This efferent output then modulates the response of the pancreatic islets with the observed changes in glucagon and insulin and of the adrenal glands with additional changes in the catechol‐amines and cortisol. The renin‐angiotensin‐aldosterone system involving the kidney and adrenal gland is another responding system. The preceding relationships are discussed in some detail. Restoration of normal neuroendocrine function is best achieved by prompt restoration of blood volume, relief of pain and anxiety, restoration of normal food intake, excision of damaged tissue, and prevention of subsequent organ failure (e.g., pulmonary).