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Homeostasis Defined
Homeostasis, according to Nirmalan and Nirmalan (2017), is the propensity for living organisms to maintain relative stability in the internal environment. Homeostasis is made possible through the cooperation of several regulatory mechanisms and separate sub-systems which make up the normal physiology of a living organism (Nirmalan & Nirmalan, 2017). During critical illnesses internal or external stress can make an attempt at interfering with the self-regulation systems beyond what is considered as normal range in physiology. According to Palaparthi and Med (2017), the word homeostasis is derived from two Greek words i.e. ‘homeo’ (stands for similar) and ‘stasis’ (standing for stable). Homeostasis is the balance, equilibrium and the stability of the body or of the cell (Palaparthi & Med, 2017). Living organisms exhibit this character. The process of maintaining stability in the internal environment necessitates occasional internal adjustments as the environmental conditions continue to change outside and inside the cell. Continuous adjustments are necessary for the achievement of stability or equilibrium.
There are three distinct mechanisms useful in homeostasis regulation and they include Osmoregulation, chemical regulation and thermoregulation (Palaparthi & Med, 2017). There are various body systems responsible for performing these mechanisms such as the respiration system, nervous system, urinary system, reproductive system and the endocrine system. Khan Academy (2018) defines homeostasis as the propensity to oppose changes for the sake of maintaining stability and an internal environment that is relatively constant. Homeostasis entails loops for negative feedback responsible for counteracting changes in the property of several target values, commonly referred to as the set points (Khan Academy, 2018). The loops for positive feedback, on the other hand, are responsible for amplifying the stimuli for initiation. These loops are responsible for stretching away from the starting point (Khan Academy, 2018).
The positive feedback system is not common in the systems of biology (Palaparthi & Med, 2017). The positive feedback functions to quicken the direction that change is taking such as in lactation. When a child is breastfeeding, mammary glands are massaged, therefore, causing the producing the prolactin hormone from the pituitary gland, where the hormone is secreted. Prolactin release occurs simultaneously in proportion to the act of breastfeeding from the baby.
Thermoregulation
The loop for negative regulation is a component of thermoregulation. It is the most common phenomena in biological system. In order to homeostasis equilibrium to be maintained the system is responsible for reversing any directional change. This helps to maintain things as they are constantly (Palaparthi & Med, 2017). For example, when the levels of carbon dioxide are high in the air we breathe internal systems cause the lungs to exhale more carbon dioxide hence resulting to increased respiration. This process helps to maintain the levels of carbon dioxide at balance and also maintain normal lung function. Another example is the rise in body temperature. When the temperature rises the body will automatically cause the hypothalamus to sense the change in temperature. This will trigger some reaction from the brain. The reaction cause the skin to release sweat and the blood vessels that are closer to the surface of the skin will dilate. This helps to lower the body temperature. The process is known as thermoregulation (Palaparthi & Med, 2017). It is a common phenomenon under the negative feedback system of regulation.
Diagram 1 and 2 below is a pictorial representation of the changes that happen during high temperatures.
Source: Khan Academy (2018)
Diagram 2
Source: Khan Academy (2018)
Osmoregulation
Osmosis is a fundamental process that occurs in the body for the purpose of ensuring proper cell function. Osmosis is the process that allows for water movement inside the body (Palaparthi & Med, 2017). The osmotic process takes place through a balancing between the backside and the front sides of cell membrane. This allows the cells’ biochemical process to take place effectively. There are two conditions that are likely to manipulate cell biochemical processes, therefore, resulting to cell death. First of all when solutes become concentrated beyond what is considered as normal in extracellular fluids a reaction will be triggered. This reaction causes movement of intracellular fluid to the extracellular space, therefore, causing the cell to shrink (Palaparthi & Med, 2017). Secondly, when extracellular fluids solute levels decline a reaction that cause the extracellular fluids to move into the cell is triggered.
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This causes the cell to sell and eventually rapture when a certain limit is exceeded.
It is fundamental to maintain stability in solute concentration in order to allow for favorable conditions for proper organisms and cell function. This balance is maintained through two homeostasis processes known as diffusion and osmosis (Palaparthi & Med, 2017). Human beings are multicellular with trillions of body cells. Most of these cells are found inside the body of the human being and for this reason most of the cells are unable to interact with the external environment directly. Blood plasma happens to be a component of extracellular fluid inside an organism. This extracellular fluid is derived from external environment. Body cells will frequently contact this extracellular fluid (Palaparthi & Med, 2017).
Chemical regulation
The regulation of glucose levels in the blood can be considered a negative feedback process. The level of blood glucose will go up after taking a meal. Insulin will be released from the pancreas after it senses a rise in blood glucose levels. Insulin is responsible for quickening the process of glucose transportation into select tissues from the blood (Palaparthi & Med, 2017). The levels of blood glucose will consequently go down. This triggers a decline…
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…& Payen, 2013). Research done recently suggests that sepsis can either indirectly or directly result to impairment of every immune cell. Sepsis causes apoptosis acceleration in nearly all the immune cells therefore decreasing the capacity for antigen, cytotoxic levels and diminished cytokine production. Sepsis also causes a reduction in the production of antibodies (Hotchkiss, Monneret & Payen, 2013). For these reasons sepsis is known to induce dysfunction in both the immune and innate immune reactions therefore contributing to damaged immune system, higher secondary infection risks and microbial challenge.
Using Metabolic Processes to Alleviating Infections among the Critically Ill
The conventional way or alleviating infection is reducing bacteria exposure among the critically ill. The process entails disinfection, surveillance and absolute hygiene as well as selective decontamination. Recent findings suggest that bacterial colonization is only the symptom of the nosocomial infection and not the cause. The two suggested strategies for alleviating infection include better control of glucose in the blood and early restriction of macronutrients as previously discussed (Ingels, Vanhorebeek & Van, 2018). When critically ill, hyperglycemia becomes an expected response to stress. It is this hyperglycemia that causes mortality and morbidity. Sustained normal glycemic levels through insulin therapy have been shown to reduce the levels of mortality and morbidity. Through rigorous insulin therapy vital body organs are protected from dysfunction and other infections are also alleviated. The favorable outcome of insulin therapy is a result of alleviation of mitochondrial damage and the toxicity of glucose to many important types of cells (including the immune cells) (Ingels, Vanhorebeek & Van, 2018). Protracted hyperglycemia experiments on animals were shown to impair oxidative burst, phagocytosis, and macrophage capacity. Through normal glycemic targets it is possible to restore the impaired capacity. Insulin therapy also has an anti-inflammatory effect that alleviates collateral damage on insulin.
Effects of critical illness on homeostasis
Intervention for prevention
Neurological failure
Mechanically ventilating the room in order to increase carbon dioxide excretion and improve oxygen intake
Healthcare care
Ventilatory failure
Healthcare care support
Mechanically ventilating the room in order to increase carbon dioxide excretion and improve oxygen intake
Hypertension
Use of anti-hypertension medication to encourage vasodilation and reduce blood volume.
Modification of one’s lifestyle such as eating foods that are low on sodium and better physical activity
Hypovolemic shock
Transfusion of blood and fluids to enhance the volume of blood in the body.
Conclusion
In order to prevent death in protracted critical illness situations it is important to institute rigorous medical healthcare. Organ failure, infections such as sepsis and nosocomial are profound threats to the recovery of a person. Managing hyperglycemia and reducing the parenteral nutrition as well as macronutrient restriction in the early stages of acute illnesses has been proven to….....
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Cuesta, J.M., Singer, M., 2012. The stress response and critical illness: A review. Critical Care Medicine 40, pp. 3283–3289.
Encyclopedia Britannica, 2018. “Homeostasis Biology” https://www.britannica.com/science/homeostasis (Last Accessed 10 October 2018)
Gentile, L.F., Cuenca, A.G., Efron, P.A., Ang, D., Bihorac, A., McKinley, B.A., Moldawer, L.L., Moore, F.A., 2012. Persistent inflammation and immunosuppression: A common syndrome and new horizon for surgical intensive care. Journal of Trauma and Acute Care Surgery.
Hotchkiss, R.S., Monneret, G., Payen, D., 2013. Sepsis-induced immunosuppression: From cellular dysfunctions to immunotherapy. Nature Reviews Immunology. doi:10.1038/nri3552
Ingels, C., Vanhorebeek, I., Van den Berghe, G., 2018. Glucose homeostasis, nutrition and infections during critical illness. Clinical Microbiology and Infection. doi:10.1016/j.cmi.2016.12.033
Khan Academy. 2018. “Homeostasis”. https://www.khanacademy.org/science/high-school-biology/hs-human-body-systems/hs-body-structure-and-homeostasis/a/homeostasis (Last Accessed 10 October 2018)
Marshall, J.C., Charbonney, E., Gonzalez, P.D., 2008. The Immune System in Critical Illness. Clinics in Chest Medicine.
Nirmalan, N., Nirmalan, M., 2017. Homeostasis in dynamic self-regulatory physiological systems. Anaesthesia and Intensive Care Medicine. doi:10.1016/j.mpaic.2017.06.018
Palaparthi, J Med P.T., 2017. “Role of Homeostasis in Human Physiology: A Review,” Journal of Medical Physiology & Therapeutics. https://www.omicsonline.org/open-access/role-of-homeostasis-in-human-physiology-a-review.pdf (Last Accessed 10 October 2018)
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