[Anisodamine in prevention and treatment of sepsis of severely burned patients].
OBJECTIVE
To observe the preventive effect of anisodamine on possible sepsis of patients with major burns and the effect of anisodamine on patients with sepsis.


METHODS
Forty-two patients with extensive burn admitted to our burn institute from April 1998 to November 1999 were divided randomly into two groups: treatment group (T group) and control group (C group). In the T group, all 20 patients received fluid resuscitation regimen with anisodamine, and in the C group, 22 patients received the regimen with no anisodamine. A tonometry catheter was positioned in the stomach, connecting with the automatic gas analysis machine (Datex-Engstrom Corporation, Dutch) for determining gastric intramucosal pH (pHi). The plasma concentrations of diamine oxidase (DAO) and endotoxin were measured. Correlation analysis between pHi, DAO and endotoxin were made respectively during early stage of postburn. All the parameters in 7 patients with sepsis before and after administration of anisodamine were compared with those in 6 patients with sepsis without use of anisodamine.


RESULTS
The incidence of sepsis in the T group was lower (20.0%) than that in C group (40.9%). The gastric pHi value in the early period of postburn was significantly higher in the T group than in the C group (P < 0.05). Concurrently, the plasma concentrations of DAO and endotoxin were significantly lower in the T group than in the C group (P < 0.05 or 0.01). A significant negative correlation was seen between the gastric pHi and respective values of DAO, endotoxin (P < 0.05 or 0.01). There were a decrease in gastric pHi, and an increase in plasma DAO and endotoxin level in patients with septic episode; however all the parameters after administration of anisodamine were improved compared with those in septic patients without use of anisodamine.


CONCLUSIONS
Intestinal ischemic injury plays an important role in provoking sepsis during early postburn period. Anisodamine is effective in restoring intestinal circulation both in the shock phase and after the development of sepsis.
Chai
J
J
Burn Institute, 304th Hospital, People's Liberation Army, Beijing 100037, China.
Yang
H
H
Sheng
Z
Z
Guo
Z
Z
Diao
L
L
Shen
C
C
Li
F
F
Jia
X
X
Li
L
L
Xu
M
M
He
L
L
Hao
D
D
Yu
Y
Y
D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D002056:Burns / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D012991:Solanaceous Alkaloids / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
D000894:Anti-Inflammatory Agents, Non-Steroidal; D012991:Solanaceous Alkaloids; C003922:anisodamine