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Metabolic response in severely traumatized patients
S M Mahmoud1, H H Mostafa, S I Belal
1Department of Forensic and Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Journal of the Egyptian Society of Parasitology
|August 1, 1992
Summary
Severe trauma significantly alters metabolism, increasing blood glucose, insulin, and cortisol while decreasing protein levels. These metabolic shifts are primarily driven by the neurohormonal response, particularly elevated cortisol.
Area of Science:
- Metabolic research
- Trauma care
- Endocrinology
Background:
- Acute severe trauma triggers significant neurohormonal responses.
- Metabolic alterations in glucose, protein, and fat are characteristic of trauma.
- Understanding these changes is crucial for patient management.
Purpose of the Study:
- To investigate the temporal relationship between serum cortisol, insulin, and metabolic changes post-trauma.
- To analyze alterations in glucose, protein, and fat metabolism in trauma patients.
Main Methods:
- Studied 30 adult polytrauma patients and 30 healthy adults.
- Measured serum cortisol, insulin, fasting blood glucose, ketones, triglycerides, total proteins, and albumin.
- Assessed metabolic parameters 2-3 days after trauma admission.
Main Results:
- Significantly increased fasting blood glucose, ketones, triglycerides, cortisol, and insulin levels observed in trauma patients.
- Significantly decreased total proteins and albumin levels in trauma patients compared to controls.
- Elevated serum cortisol levels correlated with observed metabolic changes.
Conclusions:
- Post-traumatic hyperglycemia and decreased total proteins/albumin are major metabolic consequences of severe trauma.
- These metabolic alterations are primarily mediated by neurohormonal mechanisms, notably increased cortisol levels.