Effect of injury and sepsis on high-energy phosphates in muscle and red cells.
Changes in muscle high-energy phosphates in varying degrees of resting hypermetabolism were studied. Eleven patients were investigated before and 4 days after total hip replacement. The postoperative results were compared with those seen in major traumas and sepsis. High-energy phosphates were not significantly changed in muscle after total hip replacement or moderate injury; muscle lactate and pyruvate increased. Increased degrees of hypermetabolism such as severe trauma and sepsis were associated with reduction of muscle ATP and PC; AMP, free CR, lactate, and pyruvate rose. Simultaneously determined levels of high-energy phosphates in red blood cells did not reflect muscle changes, confirming the need for continued direct tissue measurements. Alterations in the ATP--ADP--AMP system in the muscle cell suggest a low-energy charge following severe trauma especially if accompanied by sepsis. This would indicate a decreased capcity for biosynthetic reactions and production of storage compounds. Tissue high-energy phosphates and cellular energy levels thus may be the cellular expression of the catabolic state.
D000244:Adenosine Diphosphate / Q000378:metabolism; D000249:Adenosine Monophosphate / Q000378:metabolism; D000251:Adenosine Triphosphatases / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D000368:Aged; D003401:Creatine / Q000378:metabolism; D004912:Erythrocytes / Q000032:analysis*; D005260:Female; D006801:Humans; D007239:Infections / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000032:analysis*; D010710:Phosphates / Q000032:analysis* / Q000097:blood; D010725:Phosphocreatine / Q000378:metabolism; D014947:Wounds and Injuries / Q000378:metabolism*
D010710:Phosphates; D010725:Phosphocreatine; D000249:Adenosine Monophosphate; D000244:Adenosine Diphosphate; D000251:Adenosine Triphosphatases; D003401:Creatine