Document Detail


Major operative trauma increases peripheral amino acid release during the steady-state infusion of total parenteral nutrition in man.
MedLine Citation:
PMID:  3082029     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effect of major operative trauma on skeletal muscle metabolism was examined in nine patients receiving a constant infusion of calories (1460 kcal/m2/day) and protein (75 gm of amino acids/m2/day) for 5 days before and 4 days after an operation. Compared with the preoperative state, 72 hours after the operation there was a significant rise in arterial levels of glucagon, cortisol, norepinephrine, and inactive triiodothyronine and a drop in concentrations of insulin, active triiodothyronine, and amino acids. Forearm blood flow increased, as well as the efflux from forearm muscle of lactate, taurine, serine, glycine, valine, methionine, isoleucine, leucine, phenylalanine, lysine, arginine, and total amino acid nitrogen (440%). This loss of muscle protein after trauma is associated with increased muscle proteolysis, as measured by increased urinary 3-methylhistidine excretion (83%), and accounts for increased nitrogen loss (54%) from the body. Increased activity of the sympathetic nervous system is manifested by increased levels of epinephrine and norepinephrine, a relative lack of insulin, and increased levels of glucagon. This hormonal milieu plays an important role in the production of hypoaminoacidemia, increased efflux of amino acids and lactate from muscle, and negative nitrogen balance observed in these traumatized patients.
Authors:
R J Finley; R I Inculet; R Pace; R Holliday; C Rose; J H Duff; A C Groves; L I Woolf
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Surgery     Volume:  99     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1986 Apr 
Date Detail:
Created Date:  1986-04-22     Completed Date:  1986-04-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  491-500     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Amino Acids / metabolism*
Glutamates / blood
Glutamine / blood
Hormones / blood
Humans
Methylhistidines / urine
Middle Aged
Muscles / metabolism
Nitrogen / urine
Parenteral Nutrition, Total
Regional Blood Flow
Surgical Procedures, Operative*
Chemical
Reg. No./Substance:
0/Amino Acids; 0/Glutamates; 0/Hormones; 0/Methylhistidines; 56-85-9/Glutamine; 7727-37-9/Nitrogen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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