Protein Sparing Therapy during Pneumococcal Sepsis in Rhesus Monkeys.

摘要

A model was developed in the rhesus monkey to determine if the marked wasting of body proteins associated with sepsis could be prevented by an intravenous supply of various nutritional substrates. All monkeys were given a basic infusion of 0.5 g of amino acid nitrogen/kg body weight via an indwelling catheter in the jugular vein. Three groups were given either no added calories, 85 cal/kg from dextrose, or 85 calories from lipid. In each dietary group six monkeys were inoculated with 3 x 10 to the 8th power Streptococcus pneumoniae and four monkeys, heat-killed organisms. In the monkeys infused with the amino acids alone, penumococcal sepsis resulted in a four-fold increase in loss of body proteins, compared to calorie-restricted controls. Addition of 85 cal/kg/day of either dextrose or lipid markedly reduced body wasting associated with infectious disease. The calories from lipid were utilized by the septic host as a source of energy, with a slightly reduced efficiency, when compared to the isocaloric infusion of dextrose. The nitrogen sparing of the fat emulsion could not be accounted for by its glycerol content. Therefore, the septic monkey seemed to utilize fatty acids as an energy substrate. It appeared that the carbohydrate calories tended to favor the synthesis of peripheral proteins (associated mainly with skeletal muscle), while lipid calories favored synthesis of visceral proteins, such as plasma albumin and acute-phase proteins. (Author)