Urinary excretion patterns of cyclic AMP and cyclic GMP following thermal injury

Measurement of 24-h urinary cyclic AMP and cyclic GMP levels in 19 patients for up to nine days after thermal injury has revealed differences in cyclic nucleotide excretion patterns between "severe" and "mild to moderate" groups of burned patients, classified according to a predictive index of burn mortality. Cyclic AMP excretion fell significantly from a high initial level in the "severe" group, but showed no significant change in the "mild to moderate" group. Differences in cyclic AMP excretion between the two groups of patients were only significant on the second day following burn injury. There was no correlation between cyclic AMP output averaged for each patient over the first nine days and percentage body surface area of the burn or the predictive index. In contrast to the results for cyclic AMP excretion, cyclic GMP output rose significantly over the 9-day period in severely burned patients, while levels reached a plateau on days four to six for the moderate to mild group. When cyclic GMP excretion was averaged over the first nine days for each patient, a significant correlation with both percent body surface area of burn and the predictive index of burn mortality was found. The tissue source or sources which are responsible for increased cyclic GMP excretion are as yet unknown.