IMPAIRED GLUCOSE FLOW IN BURNED PATIENTS WITH GRAM-NEGATIVE SEPSIS

Abstract

Fifteen thermally injured patients with positive blood stream cultures for gram-negative organisms [Klebsiella, Pseudomonas, Enterobacter] 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 10 burned patients with sepsis and 9 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 7 patients without sepsis but exerted no effect on glucose concentrations in 6 persons with sepsis. Gram-negative sepsis in burned patients apparently impairs the increased rate of glucose production and flow to peripheral tissue which characteristically occurs after thermal injury.