Bioenergetics of the Stress Response

  • Christophe FaisyEmail author


Energy is a property of matter which obeys the two principles of thermodynamics: energy conservation within a given system and the general trend toward a higher degree of disorder, i.e., the concept of entropy (diminution of the amount of energy available within a given system). Chemical reactions in biological and biomolecular systems are based on a succession of energy transmission provided by redox reactions involving the exchange of electrons between the oxidized and the reduced organic substrates. The major energy source of all cells in aerobic organisms is adenosine triphosphate (ATP). Oxidation reactions in nutrients allow ATP synthesis by oxidative phosphorylation. The most common chemical reaction to produce energy in cells is the hydrolysis of ATP to ADP and inorganic phosphate. Before the formalization of the principles of thermodynamics, Antoine-Laurent de Lavoisier (1743–1794) has already anticipated the key principle of bioenergetics among living organisms: “Life is a slow combustion sustained by respiration. Animals are composed of fuel elements. The food replaces loss of substances arising from the combustion of matters present in the body.” Indeed, living systems are open systems drawing their energy from substrates like nutrients. This is why living organisms are fundamentally different from inert material: biochemical reactions lead to an increase in energy availability, i.e., negative entropy. What has perhaps best characterizes a living system is the negative entropy to allow a dynamic and unstable balance between this open system and its environment. See from this thermodynamic perspective, homeostasis (degree of organization of the organism) is only the consequence of the accumulation of negative entropy. It should be therefore possible to consider the frontier between life and dying processes by estimating negative entropy. This opens up new prospects in fields like critical care medicine.


Intensive Care Unit Patient Intensive Care Unit Stay Fuel Element Dissipative System Energy Deficit 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of Interest

The author has not disclosed any potential conflicts of interest.


  1. 1.
    Askanasi J, Rosenbaum SH, Hyman A, Silverberg PA, Milic-Emili J, Kinney JM (1980) Respiratory changes induced by the large glucose loads of total parenteral nutrition. JAMA 243:1444–1447CrossRefGoogle Scholar
  2. 2.
    Chaisson EJ (2002) Cosmic evolution: the rise of complexity in nature. Harvard University Press, CambridgeGoogle Scholar
  3. 3.
    Chandra RK (1997) Nutrition and the immune system: an introduction. Am J Clin Nutr 66:S460–S466Google Scholar
  4. 4.
    Cunningham-Rundles S, McNeeley DF, Moon A (2005) Mechanisms of nutrient modulation of the immune response. J Allergy Clin Immunol 56:S73–S76Google Scholar
  5. 5.
    Cuthbertson D (1942) Post-shock metabolic response. Lancet 1:433–437CrossRefGoogle Scholar
  6. 6.
    Drolz A, Wewalka M, Horvatits T, Fuhrmann V, Schneeweiss B, Trauner M, Zauner C (2014) Gender-specific differences in energy metabolism during the initial phase of critical illness. Eur J Clin Nutr 68:707–711CrossRefPubMedGoogle Scholar
  7. 7.
    Ekpe K, Novara A, Mainardi JL, Fagon JY, Faisy C (2014) Methicillin-resistant Staphylococcus aureus bloodstream infections are associated with a higher energy deficit than other ICU-acquired bacteremia. Intensive Care Med 40:1878–1887CrossRefPubMedGoogle Scholar
  8. 8.
    Faisy C, Rabbat A, Kouchakji B, Laaban JP (2000) Bioelectrical impedance analysis in estimating nutritional status and outcome of patients with chronic obstructive pulmonary disease and acute respiratory failure. Intensive Care Med 26:518–525CrossRefPubMedGoogle Scholar
  9. 9.
    Faisy C, Lerolle N, Dachraoui F, Savard JF, Abboud I, Tadie JM, Fagon JY (2009) Impact of energy deficit calculated by a predictive method on outcome in medical patients requiring prolonged acute mechanical ventilation. Br J Nutr 101:1079–1087CrossRefPubMedGoogle Scholar
  10. 10.
    Faisy C, Llerena C, Savalle M, Mainardi JL, Fagon JY (2011) Early ICU energy deficit is a risk factor of ventilator-associated pneumonia by Staphylococcus aureus. Chest 140:1254–1260CrossRefPubMedGoogle Scholar
  11. 11.
    Fiaccadori E, Morabito S, Cabassi A, Regolisti G (2014) Body cell mass evaluation in critically ill patients: killing two birds with one stone. Crit Care 18:139CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Frankenfield DC, Cooney RN, Smith JS, Rowe WA (1999) Bioelectrical impedance plethysmographic analysis of body composition in critically injured and healthy subjects. Am J Clin Nutr 69:426–431PubMedGoogle Scholar
  13. 13.
    Gallagher D, Belmonte D, Deurenberg P, Wang Z, Krasnow N, Pi-Sunyer FX, Heymsfield SB (1998) Organ-tissue mass measurement allows modeling of REE and metabolically active tissue mass. Am J Physiol Endocrinol Metab 275:E249–E258Google Scholar
  14. 14.
    Ismael S, Savalle M, Trivin C, Gillaizeau F, Dauzac C, Faisy C (2014) The consequences of sudden fluid shifts on body composition in critically ill patients. Crit Care 18:R49CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Long CL, Schaffel N, Geiger JW, Schiller WR, Blakemore WS (1979) Metabolic response to injury and illness: estimation of energy and protein needs from indirect calorimetry and nitrogen balance. JPEN J Parenter Enteral Nutr 3:452–456CrossRefPubMedGoogle Scholar
  16. 16.
    Manthous CA, Hall JB, Kushner R, Schmidt GA, Russo G, Wood LD (1995) The effect of mechanical ventilation on oxygen consumption in critically ill patients. Am J Respir Crit Care Med 151:210–214CrossRefPubMedGoogle Scholar
  17. 17.
    Pichard C, Oshima T, Berger MM (2015) Energy deficit is clinically relevant for critically ill patients: yes. Intensive Care Med 41:335–338CrossRefPubMedGoogle Scholar
  18. 18.
    Pischinger A (2007) The extracellular matrix and ground regulation: basis for a holistic biological medicine hardcover. North Atlantic Book, BerkeleyGoogle Scholar
  19. 19.
    Popp FA (1987) Neue Horizonte in der Medizin. Karl F. Haug Verlag, HeidelbergGoogle Scholar
  20. 20.
    Preiser JC, Ichai C, Orban JC, Groeneveld ABJ (2014) Metabolic response to the stress of critical illness. Br J Anaesth 113:945–954CrossRefPubMedGoogle Scholar
  21. 21.
    Prigogine I, Stenger I (1988) Entre le temps et l’éternité. Fayard, ParisGoogle Scholar
  22. 22.
    Reid CL (2004) Nutritional requirements of surgical and critically-ill patients: do we really know what they need? Proc Nutr Soc 63:467–472CrossRefPubMedGoogle Scholar
  23. 23.
    Roza AM, Schizgal HM (1984) The Harris Benedict equation reevaluated: resting energy requirements and the body cell mass. Am J Clin Nutr 40:168–182PubMedGoogle Scholar
  24. 24.
    Rubinson L, Diette GB, Song X, Brower RG, Krishnan JA (2004) Low caloric intake is associated with nosocomial bloodstream infections in patients in the medical intensive care unit. Crit Care Med 32:350–357CrossRefPubMedGoogle Scholar
  25. 25.
    Savalle M, Gillaizeau F, Puymirat E, Maruani G, Bellenfant F, Houillier P, Fagon JY, Faisy C (2012) Modeling body cell mass for a relevant nutritional assessment in critically ill patients. Am J Physiol Endocrinol Metab 303:E389–E396CrossRefPubMedGoogle Scholar
  26. 26.
    Schrödinger E (1944) What is life? The physical aspect of living cells. Cambridge University Press, CambridgeGoogle Scholar
  27. 27.
    Schutz Y (1995) The basis of direct and indirect calorimetry and their potentials. Diabetes Metab Rev 11:383–408CrossRefPubMedGoogle Scholar
  28. 28.
    Swinamer DL, Phang PT, Jones RL, Grace M, King EG (1988) Effect of routine administration of analgesia on energy expenditure in critically ill patients. Chest 92:4–10CrossRefGoogle Scholar
  29. 29.
    Taylor SJ (2007) Energy and nitrogen requirements in disease states. Smith-Gordon and Company Limited, LondonGoogle Scholar
  30. 30.
    Trager K, DeBacker D, Radermacher P (2003) Metabolic alterations in sepsis and vasoactive drug-related metabolic effects. Curr Opin Crit Care 9:271–278CrossRefPubMedGoogle Scholar
  31. 31.
    Villet S, Chiolero RL, Bollmann MD, Revelly JP, Cayeux RNM, Delarue J, Berger M (2005) Negative impact of hypocaloric feeding and energy balance on clinical outcome in ICU patients. Clin Nutr 24:502–509CrossRefPubMedGoogle Scholar
  32. 32.
    Weissman C, Kemper M, Damask MC, Askanasi J, Hyman A, Kinney JM (1984) Effect of routine intensive care interactions on metabolic rate. Chest 86:815–818CrossRefPubMedGoogle Scholar
  33. 33.
    Weissman C, Kemper M, Askanazi J, Hyman A, Kinney JM (1986) Resting metabolic rate of the critically ill patients: measured versus predicted. Anesthesiology 64:673–679CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Service de Réanimation MédicaleHôpital Européen Georges Pompidou, Assistance Publique – Hôpitaux de Paris, University Paris Descartes – Sorbonne Paris CitéParisFrance

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