Typically, the ebb phase of the stress response occurs within the first 12 to 48 hours. It is characterised by catabolism. It is driven largely by release of cytokines and hormones.
There is a decrease in the metabolic rate and at its extreme, this may prevent shivering in response to a drop in environmental temperature. The cardiac output decreases and there may be bradycardia.
There is reduced insulin secretion. This results in elevated glucose levels - diabetes of injury. Lipolysis predominates with release of free fatty acids.
Anaerobic metabolism may predominate.
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