Pharmacological Sparing of Protein in Burn Injury
Abstract
To test the responsiveness of protein kinetics to hyperinsulinemia and the maximum biological effectiveness of insulin to stimulate glucose uptake in severely burned and septic patients, isotopes of glucose, leucine and urea were infused to determine the kinetics of these substrates in 8 severely burned and 8 septic patients. Compared to the severely burned patients glucose uptake in the septic patients was depressed by 50% (12.5 + or - 0.7 mg/kg.min in burns, 6.5 + or - mg/kg.min in sepsis versus 14.0 + or - 1.3 mg/kg.min in bedrested controls). The basal rate of appearance (Ra) of leucine in the septic patients 4.08 + or - 0.22 umol/kg min was similarly elevated as in the burn patients, 5. 15 + or - 0.24 umol/kg.min when compared to controls 2.78 + or - 0.16 umol/kg. min indicating a marked stimulation in the absolute rate of protein breakdown in both groups of patients. In response to the hyperinsulinemic clamp there were significant reductions (p < 0.01) in leucine Ra in both groups of patients to 3. 39 + or - 0.14 umol/kg.min in burns, 2.99 + or - 0.19 umol/kg.min in sepsis and to 1.60 + or - 0.05 umol/kg.min in controls suggesting no impairment in the ability of insulin to restrain the absolute protein breakdown rate in both burned and septic patients. As a consequence of these reductions in the absolute rates of protein breakdown, there were marked reductions in the plasma concentrations of all amino acids.
Document Details
- Document Type
- Technical Report
- Publication Date
- May 10, 1988
- Accession Number
- ADA203390
Entities
People
- David N. Herndon
- Farook Jahoor
- Robert R Wolfe
Organizations
- University of Texas Medical Branch