Catecholamines: Mediator of the Hypermetabolic Response to Thermal Injury

摘要: Hypermetabolism characterizes the metabolic response to thermal injury and extent of energy production is positively related rate urinary catecholamine excretion. Alpha beta adrenergic blockade decreased metabolism from 69.6 ± 5.3 Kcal/m2/hr 57.4 5.2 (p < 0.01), infusion 6 µgm epinephrine/minute in normal man significantly increased rate. Twenty noninfected burned adults with a mean burn size 45% total body surface (range 7-84%) four controls were studied an environmental chamber at two or more temperatures between 19 33 C vapor pressure constant 11.88 mm Hg. All patients hypermetabolic all their core skin elevated above control values. Between 25 ambient, was unchanged burns less than 40% (48.9 4.6 vs. 48.9 4.5), but larger warmer environment (72.0 1.9 65.8 1.7, p 0.001). At 21 C, catecholamines increased, except nonsurvivors who became hypothermic catechol elaboration. Metabolic ten bacteremia below predicted levels while markedly suggesting interference tissue uptake neurohormonal transmitters. Feeding administering glucose insulin improved nitrogen retention altered substrate flow did not reduce Burned are internally warm, externally cold, appear mediate heat production. may be modified by ambient temperature, infection, pharmacologic means. Alterations hypothalamic function due injury, resulting elaboration, would explain injury.