Post injury hypermetabolic response and magnitude of translocation: prevention by early enteral nutrition.
The relationship between hypermetabolism and bacterial translocation was investigated in guinea pigs receiving a 40% burn. Animals were infused intragastrically with a complete enteral diet or Ringer's solution for 48 h, given 10(10) 14C-labeled Escherichia coli intragastrically, and killed 4 h later. Resting metabolic expenditure (RME), translocation (dpm of the 14C-labeled E. coli) to the portal blood and ileal mucosa, plasma cortisol, and urinary vanillylmandelic acid (VMA) were determined. Enterally fed animals had significantly lower RME, cortisol, VMA, and dpm, but higher mucosal and body weight than the Ringer's group. Disintegrations per minute (dpm) in the blood were positively correlated with RME (r = 0.856), cortisol (r = 0.872), VMA (r = 0.759), and dpm mucosa (r = 0.836) and inversely correlated with mucosal weight (r = -0.883). We conclude that bacterial translocation is reduced by early feeding and is an important cause of hypermetabolism and stress hormone production after burn injury.
Gianotti
L
L
Department of Surgery, University of Cincinnati, OH.
Nelson
J L
JL
Alexander
J W
JW
Chalk
C L
CL
Pyles
T
T
D000818:Animals; D001481:Basal Metabolism; D002056:Burns / Q000378:metabolism* / Q000382:microbiology*; D004734:Energy Metabolism; D004750:Enteral Nutrition; D004926:Escherichia coli / Q000502:physiology; D005260:Female; D006168:Guinea Pigs; D006854:Hydrocortisone / Q000097:blood; D007413:Intestinal Mucosa / Q000382:microbiology; D012044:Regression Analysis; D014642:Vanilmandelic Acid / Q000652:urine
D014642:Vanilmandelic Acid; D006854:Hydrocortisone