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Metabolic changes in patients severely affected by tetanus
A Hiraide1, M Katayama, H Sugimoto
1Department of Traumatology, Osaka University Medical School, Japan.
Annals of Surgery
|January 1, 1991
Summary
Severe tetanus patients exhibit increased urea nitrogen and catecholamine excretion, indicating significant metabolic changes. Neurologic factors, not just stress hormones, likely drive protein catabolism in these cases.
Area of Science:
- Metabolic Medicine
- Neurology
- Critical Care
Background:
- Tetanus is a severe infectious disease characterized by muscle spasms and autonomic dysfunction.
- Labile hypertension is a common complication in severe tetanus.
- Metabolic alterations in tetanus patients require further investigation.
Purpose of the Study:
- To investigate the metabolic changes in severely affected tetanus patients with labile hypertension.
- To assess urinary urea nitrogen and catecholamine excretion.
- To evaluate plasma cortisol and glucagon levels.
Main Methods:
- Studied six severely affected tetanus patients with labile hypertension.
- Monitored daily urinary urea nitrogen excretion.
- Measured urine catecholamine levels.
- Assessed plasma cortisol and glucagon concentrations.
Main Results:
- Urinary urea nitrogen excretion increased gradually, peaking between 8-20 days.
- Average cumulative urea nitrogen excretion over 30 days was high.
- Elevated urine catecholamine excretion was observed in all patients.
- Plasma cortisol and glucagon levels were not significantly elevated, except in one case with co-infection.
Conclusions:
- Severe tetanus induces significant protein catabolism.
- Metabolic changes are not solely explained by stress hormones.
- Neurologic factors play a crucial role in the metabolic derangements of tetanus.