Adrenal Medullary Insufficiency in Severe Thermal Burn *

Goodall, McC.; Haynes, B. W.

doi:10.1172/jci104217

Cited by 31 publications

(9 citation statements)

References 34 publications

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“…It was previously shown that of the severely burned patients that died, approximately one-third showed at the time of death a subnormal output of noradrenaline and subnormal noradrenaline content of the sympathetic ganglia and axon, a condition commensurate with sympathetic nerve depletion (11). Furthermore, over two-thirds of the cases that died showed at the time of death a subnormal output of adrenaline and an adrenal gland that was partially or totally depleted of its adrenaline and noradrenaline content (10). Whereas this depletion was not the cause of death in these patients, it nevertheless was a contributing factor and therefore imposes the question of how this depletion should be treated.…”

Section: Discussionmentioning

confidence: 99%

“…3). If the stress of severe burns continues for a protracted period of time, the adrenal medulla and the sympathetic nerves can be partially or totally depleted of their respective hormones (10,11). It was previously shown that of the severely burned patients that died, approximately one-third showed at the time of death a subnormal output of noradrenaline and subnormal noradrenaline content of the sympathetic ganglia and axon, a condition commensurate with sympathetic nerve depletion (11).…”

Section: Discussionmentioning

confidence: 99%

“…1). Infusion was purposely delayed until 3 wk after the burn, since it is at this time that the depletion of adrenaline and noradrenaline most commonly manifests itself (6,10,11 FIGURE 1 Biosynthetic pathway to the formation of noradrenaline (norepinephrine) and adrenaline (epinephrine).…”

Section: Generalmentioning

confidence: 99%

“…Goodall, Haynes, and Moncrief showed that the prolonged stress which accompanied severe thermal injury was of such magnitude that the adrenal glands could be partially or totally depleted of adrenaline (10) and the sympathetic nerves partially or totally depleted of noradrenaline (11). The purpose of this paper is to evaluate the rate of noradrenaline-adrenaline biosynthesis and utilization in severe prolonged thermal injury and thereby obtain information as to how this depletion might be treated.…”

Section: Introductionmentioning

confidence: 99%

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Dopamine (3-hydroxytyramine) replacement and metabolism in sympathetic nerve and adrenal medullary depletions after prolonged thermal injury

Goodall¹,

Alton²

1969

J. Clin. Invest.

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A B S T R A C T After severe thermal injury, the adrenal medulla and the sympathetic nerves can be partially or totally depleted of their adrenaline (epinephrine) and noradrenaline (norepinephrine). The purpose of this paper is to elucidate the rate at which dopamine-2-14C, a precursor of noradrenaline, is synthesized into noradrenaline and noradrenaline metabolic products, thereby giving some indication as to dopamine's utilization, turnover, and possible use in treating such noradrenalineadrenaline depletions. Three burned subjects, 3 wk postburn, were infused with 104.6 iLc (872 Ag) of dopamine-2-14C for 4 hr. Urine was collected at various hourly intervals for the 1st day, and thereafter for 4 days, assayed, and compared with the metabolism of dopamine in normal subjects. Methods for separating, identifying, and counting radioactivity of the various metabolic products of dopamine are described. Normally 87.6 ±3.1% of the total radioactivity is recovered within 24 hr after an infusion of dopamine-2-1'C, but in the three severely burned patients, this value was increased to 93.1, 97.3, and 97.5% in 24 hr. There was a marked decrease in the percentage of radioactivity recovered as noradrenaline in all collection periods, and in contrast to normal subjects, no radioactive noradrenaline was recovered after 24 hr. Concomitantly, there was an increase in radioactivity recovered as metabolic products of noradrenaline, reflecting a compensatory shift toward noradrenaline synthesis and utilization at the expense of the dopamine metabolic products. The results indicate that in the burned patients the infused dopamine-2-'C was rapidly synthesized into noradrenaline and then rapidly released and metabolized. From these results it seems evident that dopamine would be a useful adjunct in the treatment of sympathico-adrenal medullary depletion in burns.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Generalmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Dopamine (3-hydroxytyramine) replacement and metabolism in sympathetic nerve and adrenal medullary depletions after prolonged thermal injury

Goodall¹,

Alton²

1969

J. Clin. Invest.

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“…Although noradrenaline is also found in the adrenal medulla, adrenaline is the chief hormone of the human adrenal medulla (3,5,6). Both of these hormones are released in increased amounts under a number of stressful situations; i.e., thermal burn (7), trauma (8), X-irradiation (9), severe muscular exercise (10), and so forth.…”

mentioning

confidence: 99%