Metabolic intervention in surgical patients. An assessment of the effect of somatostatin, ranitidine, naloxone, diclophenac, dipyridamole, or salbutamol infusion on energy and protein kinetics in surgical patients using stable and radioisotopes

Journal Article · Tue Mar 01 04:00:00 EST 1988 · Ann. Surg.; (United States)

DOI:https://doi.org/10.1097/00000658-198803000-00009· OSTI ID:5295888

Shaw, J H; Wolfe, R R

We have assessed the effect of a variety of forms of metabolic intervention on both energy and protein metabolism in 44 severely ill surgical patients. The patients were studied either in the basal state or while receiving total parenteral nutrition (TPN), and the metabolic effects were assessed using the primed-constant infusion of a combination of stable isotopes and radioisotopes. Somatostatin infusion, either in the basal state or in the TPN, did not change glucose kinetics, but there was a significant decrease in the rate of net protein catabolism (NPC). In the basal studies the rate of NPC decreased from 3.4 +/- 0.7 g/kg/d to 2.9 +/- 0.7 g/kg/d (p less than 0.002), while in the TPN patients the corresponding values were 1.48 +/- 0.61 g/kg/d and 1.10 +/- 0.50 g/kg/d, respectively (p less than 0.005). Histamine type 2 blockade with ranitidine did not significantly alter glucose kinetics, but in both the TPN patients and in the basal state ranitidine was associated with a significant decrease in the rate of NPC. In the basal state rate of NPC was 2.44 +/- 0.53 g/kg/d and during ranitidine infusion the value was 2.08 +/- 0.42 g/kg/d (p less than 0.04). Naloxone infusion did not alter glucose kinetics, but there was a significant decrease in the rate of NPC from a basal value of 2.6 +/- 0.6 g/kg/d to 2.3 +/- 0.5 g/kg/d (p less than 0.04). The infusion of the prostaglandin antagonists diclofenac or dipyridamole resulted in increases in the plasma insulin level, and as a result glucose turnover decreased in both groups. In the diclofenac group the rate of glucose turnover decreased from 14.4 +/- 1.7 mumol/kg/min to 12.6 +/- 1.3 mumol/kg/min (p less than 0.02). Neither prostaglandin antagonist resulted in any significant change in the rate of NPC.

• Research Organization: Univ. Department of Surgery, Auckland (New Zealand)
• OSTI ID: 5295888
• Journal Information: Ann. Surg.; (United States), Journal Name: Ann. Surg.; (United States) Vol. 207:3; ISSN ANSUA
• Country of Publication: United States
• Language: English

Related Subjects

550501* -- Metabolism-- Tracer Techniques
59 BASIC BIOLOGICAL SCIENCES
ALDEHYDES
ANTIPYRETICS
BIOCHEMICAL REACTION KINETICS
BIOLOGICAL EFFECTS
CARBOHYDRATES
CARBON ISOTOPES
CARDIOVASCULAR AGENTS
CENTRAL NERVOUS SYSTEM DEPRESSANTS
DRUGS
GLUCOSE
HEXOSES
ISOTOPE APPLICATIONS
ISOTOPES
KINETICS
LABELLED COMPOUNDS
MEDICINE
METABOLISM
METHADONE HYDROCHLORIDE
MONOSACCHARIDES
NARCOTICS
NUTRITION
ORGANIC COMPOUNDS
PATIENTS
PROTEINS
REACTION KINETICS
SACCHARIDES
SOMATOSTATIN
SURGERY
TRACER TECHNIQUES
TRITIUM COMPOUNDS
VASODILATORS