Metabolic studies in severe burns. Clinical features, routine biochemical analyses, nitrogen balance and metabolic rate.
The effects of two isocaloric regimens for parenteral nutrition were compared on days 2 to 8 after severe burns in 16 patients. Energy expenditure, plasma catecholamines, biochemical variables and N-balance were measured. The 8 patients in group I, with mean burn size 55/25%, received fat and glucose, while the 8 in group II, mean burn size 60/40%, were given 24 g amino acid nitrogen daily in addition to the fat and glucose. The mean metabolic rate on days 2-8 after burning was 70 +/- 7 and 69 +/- 5 kcal/m2/h in groups I and II, respectively. The mean values for plasma noradrenaline in the same period were 8.35 +/- 0.89 and 7.9 +/- 0.77 nmol/l. The biochemical changes showed a pattern typical of burns. There were no intergroup differences except for urea, which was significantly higher in the group (II) receiving amino acids. The cumulative N-balance was markedly less negative 8 days after trauma (-24 g N +/- 8 g) in group II than in group I (-100 g N +/- 10 g). These results indicate that a high nitrogen intake, together with adequate energy supply, improves the N-balance significantly in the early post-burn period. The high-energy supply from fat and glucose did not seem to cause the patients additional stress.
D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001798:Blood Proteins / Q000032:analysis; D002056:Burns / Q000378:metabolism* / Q000628:therapy; D002395:Catecholamines / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D004573:Electrolytes / Q000097:blood; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007501:Iron / Q000097:blood; D008297:Male; D008657:Metabolic Clearance Rate; D009584:Nitrogen / Q000378:metabolism; D009994:Osmolar Concentration; D010288:Parenteral Nutrition; D010289:Parenteral Nutrition, Total; D014508:Urea / Q000097:blood
D001786:Blood Glucose; D001798:Blood Proteins; D002395:Catecholamines; D004573:Electrolytes; D006454:Hemoglobins; D014508:Urea; D002784:Cholesterol; D007501:Iron; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D009584:Nitrogen