Endocrine and Metabolic Response to Shock and Trauma

摘要

A splenectomized-pancreatectomized-adrenalectomized monkey (SPAM) model was used to investigate the role of adrenal and pancreatic hormones in post shock metabolism; the first study demonstrated that hemorrhagic shock did not induce negative nitrogen balance in either the SPAMs or controls. However, evidence from in vitro muscle studies was found for protein catabolism from leucine oxidation and for luecine incorporation in protein synthesis. A second study demonstrated that hyperglucagonemia does not cause nitrogen loss in well-alimented monkeys after shock. Those animals receiving reduced calories showed a reduced nitrogen loss when glucagon was eliminated. In a third study, alterations in muscle leucine metabolism were observed, despite replacement therapy with insulin and cortisol. Animals given low calorie alimentation showed suppressed protein synthesis which was reversed by providing adequate calories. In this model, the characteristic metabolic picture and insulin resistance persist without the characteristic endocrine trauma response. A second series of studies was performed to determine the existence of circadian rhythm of corticosteroids in baboons and rhesus monkeys. Adrenalectomized rhesus monkeys showed circadian and infradian cycles during a constant infusion of cortisol.