The stated objective of this program is to quantitatively evaluate various biochemical and physiological parameters in the critically ill and injured patient. The pathophysiology of trauma has been expressed by a number of overt clinical changes manifested by the patient which serve to emphasize the severity and seriousness of trauma, """"""""the forgotten disease."""""""" The past year ended with the phasing out of the old hospital facility and moving into a new teaching hospital. Many systems of the Surgical Metabolism Facility (SMF) have been updated, including measurements of metabolic expenditures in patients on respirators. Urinary losses of trace minerals, Zn and Cu, are tremendously increased following trauma. Hyperalimentation also causes increased losses. Following injury patients' immune competence has also been shown to be suppressed. The increased gluconeogenic response following trauma correlates well with the nonketotic response observed in 21 patients on a carbohydrate free diet for 3 days. RQ values suggested fat mobilization, however, not excessively so. The gluconeogenic response appears to be the consequence of muscle protein metabolism in such a high catabolic state. These studies will continue in an effort to understand these metabolic changes and how to cope with them to favor appropriate patient convalescence.
|Turinsky, J; Long, C L (1990) Free amino acids in muscle: effect of muscle fiber population and denervation. Am J Physiol 258:E485-91|
|Velasco, N; Long, C L; Otto, D A et al. (1990) Comparison of three methods for the estimation of total nitrogen losses in hospitalized patients. JPEN J Parenter Enteral Nutr 14:517-22|
|Long, C L; Nelson, K M; Akin Jr, J M et al. (1990) A physiologic basis for the provision of fuel mixtures in normal and stressed patients. J Trauma 30:1077-85;discussion 1085-6|
|Long, C L; Dillard, D R; Bodzin, J H et al. (1988) Validity of 3-methylhistidine excretion as an indicator of skeletal muscle protein breakdown in humans. Metabolism 37:844-9|