Pharmacological Sparing of Protein and Glucose in Burn Injury and/or Sepsis

摘要

The metabolic effect of lowering glucagon concentration in severely burned patients by means of somatostatin infusion was assessed. In one case the insulin concentration was also decreased (by virtue of inhibition of secretion by somatostatin), and in the second protocol the basal insulin concentration was replaced. Primed-constant infusions of 6,6-d2-glucose and 3-13 C-alanine were used to measure glucose and alanine kinetics. The results of this study indicated that hyperglucagonemia stimulates glucose production in severely burned patients, whereas basal insulin plays a role in suppressing glucose production, stimulating glucose clearance, and regulating the rate of release of amino acids from peripheral tissues. Thus, pharmacological inhibition of glucagon activity should have an anabolic effect in burned patients. However, this cannot be achieved by infusing somatostatin alone, since the concomitant inhibition of insulin will counteract any beneficial effect of reducing glucagon. Keywords: Wounds and injuries; Burns.