Advertisement
Surgery
Advanced searchSave search
Original communication| Volume 83, ISSUE 2, P138-143, February 1978

Download started.

Ok

Arterial plasma amino acids in patients with severe burns

  • Alan C. Groves
    Correspondence
    Reprint requests: Alan C. Groves, M.D., F.R.C.S.(C.), Department of Surgery, Shaughnessy Hospital, 4500 Oak St., Vancouver, British Columbia, V6H 3N1, Canada.
    Affiliations
    From the Department of Surgery, Shaughnessy Hospital and the University of British Columbia, and the Department of Psychiatry, Kinsmen Laboratory of Neurological Research, University of British Columbia, Vancouver, British Columbia, Canada
    Search for articles by this author
  • J.Paul Moore
    Affiliations
    From the Department of Surgery, Shaughnessy Hospital and the University of British Columbia, and the Department of Psychiatry, Kinsmen Laboratory of Neurological Research, University of British Columbia, Vancouver, British Columbia, Canada
    Search for articles by this author
  • Louis I. Woolf
    Affiliations
    From the Department of Surgery, Shaughnessy Hospital and the University of British Columbia, and the Department of Psychiatry, Kinsmen Laboratory of Neurological Research, University of British Columbia, Vancouver, British Columbia, Canada
    Search for articles by this author
  • John H. Duff
    Affiliations
    From the Department of Surgery, University Hospital and the University of Western Ontario, London, Ontario, Canada
    Search for articles by this author
DOI:https://doi.org/10.5555/uri:pii:0039606078902702
Arterial plasma amino acids in patients with severe burns
Previous ArticleSelective arterial embolization for control of traumatic pelvic hemorrhage
Next ArticlePlatelet function abnormalities in a family with recurrent arterial thrombosis
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Arterial plasma amino acids and glucagon, blood glucose, and serum insulin were measured in 10 patients on the second and third days after severe thermal injury and at the same time in 10 control patients following uncomplicated abdominal operations. On the second and third days in patients with burns, plasma glucagon (460.1 ± 270.4 and 331.0 ± 187.1 pg/ml, respectively) was higher than in the controls (p < 0.01, p < 0.05). Glucose was greater in burned patients than in controls on the second day (171.1 ± 66.1 mg%, p < 0.05) and on the third day (164.4 ± 49.0 mg%, p < 0.01); insulin was higher in those with burns on day three (45.7 ± 33.8 μU/ml, p < 0.05). The insulin:glucagon molar ratios in the two groups were not significantly different, suggesting that there are other factors which control the catabolic rate. On day two, in patients with burns, phenylalanine (79.9 ± 20.9 μmole/liter) and the key glucogenic amino acid, alanine, (387.2 ± 207.1 μmole/liter) were elevated and greater than in the controls (p < 0.05, p < 0.05). Phenylalanine remained elevated on the third day after thermal injury (87.7 ± 14.9 μmole/liter, p < 0.001). In the burned group, but not in the controls, there was a correlation between alanine and phenylalanine on both days (r = 0.73, p < 0.05, r = 0.82, p < 0.01). There was no correlation between alanine and glucagon in either group. These data suggest impaired liver metabolism following severe burns.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Allison S.P.
        • Hinton P.
        • Chamberlain M.J.
        Intravenous glucose tolerance, insulin, and free fatty acid levels in burned patients.
        Lancet. 1968; 2: 1113
        • Ayling J.E.
        Phenylalanine hydroxylase in human kidney; relevance to phenylketonuria.
        in: UCLA Forum Med Sci. 18. 1975: 459
        • Ayling J.E.
        • Helfand G.A.
        • Pirson W.D.
        Phenylalanine hydroxylase from human kidney.
        Enzyme. 1975; 20: 6
        • Campbell R.M.
        • Sharp G.
        • Boyne A.A.
        • et al.
        Cortisone and the metabolic response to injury.
        Br J Exp Pathol. 1954; 35: 566
        • Czaja A.J.
        • Rizzo T.A.
        • Smith W.R.
        • et al.
        Acute liver disease after cutaneous thermal injury.
        J Trauma. 1975; 15: 887
        • Duke J.H.
        • Jorgensen S.B.
        • Broell J.R.
        • et al.
        Contribution of protein to caloric expenditure following injury.
        Surgery. 1970; 68: 168
        • Exton J.H.
        • Friedmann N.
        • Wong E.H.
        • et al.
        Interaction of glucocorticoids with glucagon and epinephrine in the control of gluconeogenesis and glycogenolysis in the liver and of lipolysis in adipose tissue.
        J Biol Chem. 1972; 247: 3579
        • Faloona G.R.
        • Unger R.H.
        Glucagon.
        in: Jaffe B.M. Behrman H.R. Methods of hormone radioimmunoassay. Academic Press Inc, New York1974: 317 (editors:)
        • Felig P.
        • Brown W.V.
        • Levine R.A.
        • et al.
        Glucose homeostasis in viral hepatitis.
        N Engl J Med. 1970; 283: 1436
        • Felig P.
        • Owen O.E.
        • Wahren J.H.
        • et al.
        Amino acid metabolism during prolonged starvation.
        J Clin Invest. 1969; 48: 584
        • Felig P.
        • Wahren J.
        Influence of endogenous insulin secretion on splanchnic glucose and amino acid metabolism in man.
        J Clin Invest. 1971; 50: 1702
        • Franksson C.
        • Gemzell C.A.
        • von Euler U.S.
        Cortical and medullary adrenal activity in surgical and allied conditions.
        J Clin Endocrinol. 1954; 14: 608
        • Giddings A.E.B.
        • Clark R.G.
        • O'Connor K.J.
        • et al.
        Plasma glucagon and insulin:glucagon ratios after abdominal surgery.
        Br J Surg. 1974; 61: 920
        • Goodall C.McC.
        • Stone C.
        • Haynes Jr., B.W.
        Urinary output of adrenalin and noradrenalin in severe thermal burns.
        Ann Surg. 1957; 145: 479
        • Iber F.L.
        • Rosen H.
        • Levenson S.M.
        • et al.
        The plasma amino acids in patients with liver failure.
        J Lab Clin Med. 1957; 50: 417
        • Marliss E.B.
        • Aoki T.T.
        • Unger R.H.
        • et al.
        Glucagon levels and metabolic effects in fasting man.
        J Clin Invest. 1970; 49: 2256
        • Owen O.E.
        • Cahill G.F.
        Metabolic effects of exogenous glucocorticoids in fasted man.
        J Clin Invest. 1973; 52: 2596
        • Reiss E.
        • Pearson E.
        • Artz C.
        The metabolic response to burns.
        J Clin Invest. 1956; 35: 62
        • Spivey J.
        • Johnston I.D.A.
        The effect of environmental temperature and nutritional intake on the metabolic response to abdominal surgery.
        Br J Surg. 1972; 59: 93
        • Unger R.H.
        Glucagon physiology and pathophysiology.
        N Engl J Med. 1971; 285: 443
        • Unger R.H.
        Glucagon and the insulin:glucagon molar ratio in diabetes and other catabolic illness.
        Diabetes. 1971; 20: 834
        • Wahren J.
        • Felig P.
        • Hagenfeldt L.
        Effect of protein ingestion on splanchnic and leg metabolism in normal man and in patients with diabetes mellitus.
        J Clin Invest. 1976; 57: 987
        • Wahren J.
        • Felig P.
        • Cerasi E.
        • et al.
        Splanchnic and peripheral glucose and amino acid metabolism in diabetes mellitus.
        J Clin Invest. 1972; 51: 1870
        • Wilmore D.W.
        • Mason A.D.
        • Pruitt B.A.
        Insulin response to glucose in hypermetabolic burn patients.
        Ann Surg. 1976; 183: 314
        • Wilmore D.W.
        • Mason A.D.
        • Pruitt B.A.
        Impaired glucose flow in burned patients with gram-negative sepsis.
        Surg Gynecol Obstet. 1976; 143: 720
        • Wilmore D.W.
        • Lindsey C.A.
        • Moylan J.A.
        • et al.
        Hyperglucagonemia after burns.
        Lancet. 1974; 1: 73
        • Wise J.K.
        • Hendler R.
        • Felig P.
        Influence of glucocorticoids on glucagon secretion and plasma amino acid concentrations in man.
        J Clin Invest. 1973; 52: 2774
        • Woolf L.I.
        • Cranston W.I.
        • Goodwin B.L.
        Genetics of phenylketonuria.
        Nature. 1967; 213: 882
        • Woolf L.I.
        • Groves A.C.
        • Moore J.P.
        • et al.
        Arterial plasma amino acids in patients with serious postoperative infection and in patients with major fractures.
        Surgery. 1976; 79: 283

      Article info

      Publication history

      Accepted: March 31, 1977

      Footnotes

      ☆Supported by grants from the British Columbia Medical Services Foundation and the Medical Research Council of Canada.

      Identification

      DOI: https://doi.org/10.5555/uri:pii:0039606078902702

      Copyright

      © 1978 Published by Elsevier Inc.

      ScienceDirect

      Access this article on ScienceDirect

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX