Endogenous protein-synthesis efficiency in trauma victims.
Hyperglycemia despite increased glucose oxidation and hypoaminoacidemia despite increased rate of protein breakdown are frequently seen in hypermetabolic and highly catabolic patients with major trauma. The extent of reutilization of endogeneously produced amino acids in the synthesis of new proteins (protein recycling) by the traumatized human is poorly understood. The protein synthesis efficiency was measured in ten multiple trauma patients during the early "flow" phase of injury, and these data were compared with normal and depleted patients. In acute trauma the synthetic efficiency of protein is significantly (P = .01) low (61% +/- 4%) compared with other pathologic states (78% +/- 1%). This suggests that the priority is preferentially set to meet the increased demands of glucose production, and a major portion of the amino acids are utilized for purposes other than synthesis of body proteins. This observation should be taken into account in the early management of acute trauma patients before the body adapts to accept the exogenous supply of amino acids.
Jeevanandam
M
M
Trauma Center, St Joseph's Hospital & Medical Center, Phoenix, AZ 85013.
Young
D H
DH
Schiller
W R
WR
D000209:Acute-Phase Proteins / Q000378:metabolism*; D000222:Adaptation, Physiological; D000328:Adult; D000368:Aged; D000596:Amino Acids / Q000378:metabolism; D001774:Blood Chemical Analysis; D002153:Calorimetry, Indirect; D004734:Energy Metabolism; D005260:Female; D005943:Gluconeogenesis; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D009751:Nutritional Requirements; D014176:Protein Biosynthesis; D014947:Wounds and Injuries / Q000097:blood / Q000378:metabolism*
D000209:Acute-Phase Proteins; D000596:Amino Acids