[Changes in blood glucose and plasma osmolality in postburn multiple system organ failure]

Retrospective analysis of 58 burn patients (greater than or equal to 60% TBSA) were performed. 38 patients associated with MSOF according to the criteria stated by Eiseman. Glucose and osmolality were examined continuously in all patients. Glucose was determined by using a glucose oxidase method, and osmolality by freezing-point depression method. We investigated the relationship between the incidence of MSOF and changes in glucose and osmolality in burn patients. The present study showed that, (1) Glucose and osmolality were significantly higher in group of MSOF than group of non-MSOF from the third day postburn. (2) The elevation of glucose and osmolality in patients with MSOF dominated about four days earlier than the development of MSOF. (3) The osmolality was markedly higher after renal failure than before, but the glucose was not. (4) The incidence rate of MSOF increased as the elevation of glucose and osmolality. This paper suggested that, (1) The hypermetabolic situation of posttrauma is one of the important causes of MSOF. (2) The occurrence of acute renal failure induced metabolic disturbance and had an adverse effect on other organs. (3) Continuous determination of glucose and osmolality in severe trauma patients may be useful in the early diagnosis of MSOF.