Effects of Burn Injury on Markers of Hypermetabolism in Rats

Izamis, Maria-Louisa; Uygun, Korkut; Uygun, Basak E.; Yarmush, Martin L.; Berthiaume, François

doi:10.1097/bcr.0b013e3181bfb7b4

Cited by 12 publications

(8 citation statements)

References 31 publications

(25 reference statements)

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“…It has been shown that whole-body parameters of hypermetabolism post-burn injury, including heart rate and temperature, are elevated and/or stable on post-burn day 4 for rats of this age (Izamis et al, 2009). Therefore, this time point was selected for the studies herein.…”

Section: Methodsmentioning

confidence: 99%

In situ metabolic flux analysis to quantify the liver metabolic response to experimental burn injury

Izamis

Sharma

Uygun

et al. 2010

Biotech & Bioengineering

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Trauma such as burns induces a hypermetabolic response associated with altered central carbon and nitrogen metabolism. The liver plays a key role in these metabolic changes; however, studies to date have evaluated the metabolic state of liver using ex vivo perfusions or isotope labeling techniques targeted to specific pathways. Herein, we developed a unique mass balance approach to characterize the metabolic state of the liver in situ, and used it to quantify the metabolic changes to experimental burn injury in rats. Rats received a sham (control uninjured), 20% or 40% total body surface area (TBSA) scald burn, and were allowed to develop a hypermetabolic response. One day prior to evaluation, all animals were fasted to deplete glycogen stores. Four days post-burn, blood flow rates in major vessels of the liver were measured, and blood samples harvested. We combined measurements of metabolite concentrations and flow rates in the major vessels entering and leaving the liver with a steady-state mass balance model to generate a quantitative picture of the metabolic state of liver. The main findings were: (1) Sham-burned animals exhibited a gluconeogenic pattern, consistent with the fasted state; (2) the 20% TBSA burn inhibited gluconeogenesis and exhibited glycolytic-like features with very few other significant changes; (3) the 40% TBSA burn, by contrast, further enhanced gluconeogenesis and also increased amino acid extraction, urea cycle reactions, and several reactions involved in oxidative phosphorylation. These results suggest that increasing the severity of injury does not lead to a simple dose-dependent metabolic response, but rather leads to qualitatively different responses.

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Section: Methodsmentioning

confidence: 99%

In situ metabolic flux analysis to quantify the liver metabolic response to experimental burn injury

Izamis

Sharma

Uygun

et al. 2010

Biotech & Bioengineering

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“…Hypermetabolism typically occurs after severe burns and persists in parallel to, or beyond, the original pathology, as an often-fatal comorbidity [23]. Increase in catecholamines, inflammatory mediators and basal energy expenditure, along with significant loss of muscle protein, bone mineral content and bone mineral density, are some of the important metabolic changes that occur after a major burn.…”

Section: Metabolic Changesmentioning

confidence: 99%

Analgesia and sedation for children undergoing burn wound care

Bayat

Ramaiah

Bhananker

2010

Expert Review of Neurotherapeutics

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Standard care of burn wounds consists of cleaning and debridement (removing devitalized tissue), followed by daily dressing changes. Children with burns undergo multiple, painful and anxiety-provoking procedures during wound care and rehabilitation. The goal of procedural sedation is safe and efficacious management of pain and emotional distress, requiring a careful and systematic approach. Achieving the best results needs understanding of the mechanisms of pain and the physiologic changes in burn patients, frequent evaluation and assessment of pain and anxiety, and administration of suitable pharmacological and nonpharmacological therapies. Pharmacological therapies provide the backbone of analgesia and sedation for procedural pain management. Opioids provide excellent pain control, but they must be administered judiciously due to their side effects. Sedative drugs, such as benzodiazepines and propofol, provide excellent sedation, but they must not be used as a substitute for analgesic drugs. Ketamine is increasingly used for analgesia and sedation in children as a single agent or an adjuvant. Nonpharmacological therapies such as virtual reality, relaxation, cartoon viewing, music, massage and hypnosis are necessary components of procedural sedation and analgesia for children. These can be combined with pharmacological techniques and are used to limit the use of drugs (and hence side effects), as well as to improve patient participation and satisfaction. In this article, we review the pathophysiologic changes associated with major thermal injury in children, the options available for sedation and analgesia for wound care procedures in these children and our institutional guidelines for procedural sedation.

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“…It has been observed that rats with full thickness burn ≥30% total body surface area (TBSA) have an acute hypermetabolic response similar to that reported in humans [7,17,18], persisting for over 14 days post injury [17-19]. The increase in metabolism was associated with a reduction in body protein and fat content when animals were held on a restricted diet [20,21].…”

Section: Introductionmentioning

confidence: 98%

Severe burn and disuse in the rat independently adversely impact body composition and adipokines

Wade

Baer

et al. 2013

Crit Care

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IntroductionSevere trauma is accompanied by a period of hypermetabolism and disuse. In this study, a rat model was used to determine the effects of burn and disuse independently and in combination on body composition, food intake and adipokines.MethodsMale rats were assigned to four groups 1) sham ambulatory (SA), 2) sham hindlimb unloaded (SH), 3) 40% total body surface area full thickness scald burn ambulatory (BA) and 4) burn and hindlimb unloaded (BH). Animals designated to the SH and BH groups were placed in a tail traction system and their hindlimbs unloaded. Animals were followed for 14 days. Plasma, urine, fecal and tissue samples were analyzed.ResultsSA had a progressive increase in body mass (BM), SH and BA no change and BH a reduction. Compared to SA, BM was reduced by 10% in both SH and BA and by 17% when combined in BH. Compared to SA, all groups had reductions in lean and fat body mass with BH being greater. The decrease in lean mass was associated with the rate of urinary corticosterone excretion. The loss in fat mass was associated with decreases in plasma leptin and adiponectin and an increase in ghrelin. Following the acute response to injury, BH had a greater food intake per 100 g BM. Food intake was associated with the levels of leptin, adiponectin and ghrelin.ConclusionsThe effects of the combination of burn and disuse in this animal model were additive, therefore in assessing metabolic changes with severe trauma both injury and disuse should be considered. Furthermore, the observed changes in adipokines, corticosterone and ghrelin provide insights for interventions to attenuate the hypermetabolic state following injury, possibly reducing catabolism and muscle loss and subsequent adverse effects on recovery and function.

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Effects of Burn Injury on Markers of Hypermetabolism in Rats

Cited by 12 publications

References 31 publications

In situ metabolic flux analysis to quantify the liver metabolic response to experimental burn injury

In situ metabolic flux analysis to quantify the liver metabolic response to experimental burn injury

Analgesia and sedation for children undergoing burn wound care

Severe burn and disuse in the rat independently adversely impact body composition and adipokines

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