Early stage of trauma is characterized by -

• Injury Phase (Phase of catabolism): −− Begins at the time of injury and lasts for 2-5 days −− Phase of hypermetabolism −− Stress hormones (cortisol, catecholamines and glucagon) and volume control hormones (renin-angiotensin, aldosterone and ADH) are increased. This leads to proteolysis, lipolysis, hyperglycemia and wound healing despite of negative nitrogen balance. • Turning Point: −− Transient period marked physiologically by turning off of the neuroendocrine response and clinically by the appearance of getting well. • Early Anabolic Phase: −− Marked by gain in muscular strength or positive nitrogen balance. • Late Anabolic Phase: −− Marked by gain in weight and body fat or positive caloric balance