Document Detail


Extent and magnitude of catecholamine surge in pediatric burned patients.
MedLine Citation:
PMID:  20407405     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Increased catecholamine (CA) levels after severe burn are associated with stress, inflammation, hypermetabolism, and impaired immune function. The CA secretion profiles in burned patients are not well described. Mechanisms, duration, and extent of CA surge are unknown. The purpose of this large unicenter study was to evaluate the extent and magnitude of CA surge after severe burn in pediatric patients. Patients admitted between 1996 and 2008 were enrolled in this study. Twenty-four-hour urine collections were performed during acute hospitalization and up to 2 years postburn. Results from the samples collected from 12 normal, healthy volunteers were compared with the data from the burned patients. Relevant demographic and clinical information was obtained from medical records. Student t-test and one-way ANOVA were used to analyze the data where appropriate. Significance was accepted at P < 0.05. Four hundred thirteen patients were enrolled in this study; 17 patients died during acute hospitalization. Burn caused a marked stress and inflammatory response, indicated by massive tachycardia and elevated proinflammatory cytokines. In burned patients, CA levels are consistently and significantly modulated after burn when compared with the levels in normal, healthy volunteers. Catecholamine levels were significantly higher in boys compared with girls, correlated with burn size in burns greater than 40%, and were increased in older children. There were differences over time in survivors versus nonsurvivors, with CA levels significantly higher in nonsurvivors at two time points. Inflammatory cytokines show a similar profile during the study period. Our study gives clinicians a useful insight into the extent and magnitude of CA elevation to better design treatment strategies.
Authors:
Gabriela A Kulp; David N Herndon; Jong O Lee; Oscar E Suman; Marc G Jeschke
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Shock (Augusta, Ga.)     Volume:  33     ISSN:  1540-0514     ISO Abbreviation:  Shock     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-21     Completed Date:  2010-07-19     Revised Date:  2014-09-24    
Medline Journal Info:
Nlm Unique ID:  9421564     Medline TA:  Shock     Country:  United States    
Other Details:
Languages:  eng     Pagination:  369-74     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Factors
Burns / pathology,  physiopathology*,  urine
Catecholamines / urine*
Child
Child, Preschool
Cytokines / urine
Dopamine / urine
Epinephrine / urine
Female
Granulocyte Colony-Stimulating Factor / urine
Heart Rate
Humans
Inflammation / physiopathology,  urine
Interleukin-6 / urine
Interleukin-8 / urine
Male
Norepinephrine / urine
Sex Factors
Tumor Necrosis Factor-alpha / urine
Grant Support
ID/Acronym/Agency:
P50 GM060338/GM/NIGMS NIH HHS; P50 GM060338-06/GM/NIGMS NIH HHS; P50 GM060338-060001/GM/NIGMS NIH HHS; P50 GM060338-069003/GM/NIGMS NIH HHS; P50 GM060338-069005/GM/NIGMS NIH HHS; P50 GM060338-090001/GM/NIGMS NIH HHS; P50 GM060338-09S1/GM/NIGMS NIH HHS; P50 GM60338/GM/NIGMS NIH HHS; R01 GM056687/GM/NIGMS NIH HHS; R01 GM056687-10/GM/NIGMS NIH HHS; R01-GM56687/GM/NIGMS NIH HHS; T32 GM008256/GM/NIGMS NIH HHS; T32 GM008256/GM/NIGMS NIH HHS; T32 GM008256-19/GM/NIGMS NIH HHS
Chemical
Reg. No./Substance:
0/Catecholamines; 0/Cytokines; 0/Interleukin-6; 0/Interleukin-8; 0/Tumor Necrosis Factor-alpha; 143011-72-7/Granulocyte Colony-Stimulating Factor; VTD58H1Z2X/Dopamine; X4W3ENH1CV/Norepinephrine; YKH834O4BH/Epinephrine
Comments/Corrections

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