Hormonal and metabolic changes following severe head injury or noncranial injury.

Détails

ID Serval
serval:BIB_986AA02173AD
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Hormonal and metabolic changes following severe head injury or noncranial injury.
Périodique
Journal of Parenteral and Enteral Nutrition
Auteur(s)
Chioléro R., Schutz Y., Lemarchand T., Felber J.P., de Tribolet N., Freeman J., Jéquier E.
ISSN
0148-6071 (Print)
ISSN-L
0148-6071
Statut éditorial
Publié
Date de publication
1989
Volume
13
Numéro
1
Pages
5-12
Langue
anglais
Résumé
In order to evaluate the effect of head injury in severely traumatized patients on the response of plasma cortisol, glucagon, insulin, glucose, and FFA as well as urinary N and catecholamines excretions, 36 patients were prospectively studied over 5 consecutive days following injury. They were divided into three groups: group I, severe isolated head injury (n = 14); group II, multiple injury combined with severe head injury (n = 12); group III multiple injury without head injury (n = 10). The results demonstrate similar hormonal and metabolic changes between these three groups of patients, characterized by elevated urinary adrenaline, noradrenaline excretion, increased cortisol, glucagon, insulin plasma levels throughout the study and elevated N urinary excretion with strongly negative N balances during the first 5 days postinjury. A significant correlation was observed between N intake and 5 day cumulated N balance (r = 0.63, p less than 0.001). In addition, N balance was negatively correlated with urinary excretion of adrenaline (r = -0.47, p less than 0.01) and noradrenaline (r = -0.44, p less than 0.05) as well as plasma levels of glucagon (r = -0.44, p less than 0.05). Isolated severe head injury seems to induce a full response in the secretion of the catabolic counterregulatory hormones comparable to that encountered in patients with multiple injury and associated with a marked increase in protein catabolism; additional noncranial major injury does not seem to enhance these responses.
Mots-clé
Adolescent, Adrenal Cortex Hormones/secretion, Adult, Craniocerebral Trauma/complications, Craniocerebral Trauma/metabolism, Female, Humans, Male, Middle Aged, Nitrogen/metabolism, Pancreatic Hormones/secretion, Wounds and Injuries/complications, Wounds and Injuries/metabolism
Pubmed
Web of science
Création de la notice
21/01/2008 14:08
Dernière modification de la notice
20/08/2019 16:00
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