Impaired glucose flow in burned patients with gram-negative sepsis

Fifteen thermally injured patients with positive blood stream cultures for gram-negative organisms demonstrated a decreased mass flow of glucose through the glucose space when compared with 17 patients without sepsis studied at a comparable time after injury. Amino acid concentrations determined in ten burned patients with sepsis and nine burned patients without sepsis revealed an increase in the gluconeogenic precursors alanine, glycine, methionine and phenylalanine in those patients with sepsis. The administration of alanine consistently increased serum glucose in seven patients without sepsis but exerted no effect on glucose concentrations in six person with sepsis. These data, taken together, indicate that gram-negative sepsis in burned patients impairs the increased rate of glucose production and flow to peripheral tissue which characteristically occurs after thermal injury.