Glucose and lactate kinetics in burn shock

Area of Science:

• Biochemistry
• Physiology
• Trauma Medicine

Background:

• Burn injury triggers significant metabolic derangements.
• Understanding substrate kinetics is vital for managing burn shock.

Purpose of the Study:

• To investigate glucose and lactate kinetics during burn shock.
• To elucidate the metabolic alterations in burn injury.

Main Methods:

• Primed constant infusion of radiolabeled glucose ([6-3H]glucose) and lactate (Na-L-(+)-[U-14C]lactate).
• Measurement of substrate appearance (Ra) and disappearance (Rd) rates.
• Monitoring of plasma glucose and lactate concentrations.

Main Results:

• Early postburn hyperglycemia observed, driven by increased glucose Ra.
• Impaired tissue glucose extraction exacerbated hyperglycemia.
• Rapid rise in lactate Ra, with delayed increase in lactate Rd, leading to a 350% plasma lactate increase.
• Sustained elevated lactate Ra, Rd, and plasma concentrations post-30 minutes.

Conclusions:

• Lactate plays a critical role in the metabolic response to burn shock.
• Altered glucose and lactate kinetics are key features of burn shock pathophysiology.
• Findings highlight the importance of lactate in burn trauma substrate metabolism.