ENERGY CHARGE POTENTIAL AND GLUTATHIONE LEVELS AS PREDICTORS OF OUTCOME FOLLOWING BURN INJURY COMPLICATED BY ENDOTOXEMIA
| Autor: | Ulhas Nayak, John Hennigan, Cheryl Lalonde, Robert H. Demling |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Burn injury
medicine.medical_specialty Erythrocytes Antioxidant medicine.medical_treatment education chemistry.chemical_element Inflammation Critical Care and Intensive Care Medicine Oxygen Antioxidants Rats Sprague-Dawley chemistry.chemical_compound Oxygen Consumption fluids and secretions Internal medicine medicine Animals Energy charge Chemistry Glutathione Prognosis Endotoxemia Rats Surgery Red blood cell Treatment Outcome medicine.anatomical_structure Endocrinology Solubility Emergency Medicine medicine.symptom Burns Energy Metabolism Total body surface area |
| Zdroj: | Shock. 9:27-32 |
| ISSN: | 1073-2322 |
| DOI: | 10.1097/00024382-199801000-00004 |
| Popis: | We studied the effect of water-soluble antioxidants geared at restoring glutathione levels on oxygen consumption, cell energetics as measured by energy charge potential (ECP), glutathione levels, and mortality, in response to a 20% total body surface area (TBSA) third degree burn injury combined with endotoxemia, five days after burn in a rat model. The 20% TBSA third degree burn injury was not fatal for the six day study period. Oxygen consumption as well as red blood cell ECP remained unchanged from control values. Liver ECP was significantly reduced; however, liver glutathione was significantly increased. The 20% TBSA burn injury combined with endotoxemia produced a 60% mortality rate. Twenty-four hour survivors (40%) demonstrated a significant decrease in oxygen consumption, red blood cell ECP, and liver ECP. Liver glutathione was significantly decreased compared with burn but was not significantly decreased compared with control. Nonsurvivors of the burn injury combined with endotoxin (60%) demonstrated a significant reduction in liver glutathione levels compared with survivors. Oxygen consumption and ECP could not be measured in the nonsurvivors due to the rapid loss of ATP in the moribund state that occurred by 4 h postinjury. Antioxidants produced 100% survival, attenuated in the fall in liver ECP, and restored red blood cell ECP and liver glutathione levels to normal values. We conclude that a modest burn injury combined with endotoxemia produces a liver glutathione debt, oxygen debt, an energy deficit, and 60% mortality. The mechanism of injury is oxidant related as antioxidants prevented mortality restored liver glutathione levels, and prevented or attenuated the decrease in ECP. A decrease in ECP and glutathione levels appear to be more sensitive indicators of outcome than the presence of an oxygen debt. The survivors, in both burn plus endotoxin groups treated with or without antioxidants was comparable, indicating a critical value for oxygen consumption exists before death occurs. |
| Databáze: | OpenAIRE |
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