Effects of Hypercaloric Glucose Infusion on Lipid Metabolism in Injury and Sepsis

Authors:
  • YCYvon A. Carpentier
    Yvon A. Carpentier
  • JAJeffrey Askanazi
    Jeffrey Askanazi
  • DEDavid H. Elwyn
    David H. Elwyn
  • MJMalayappa Jeevanandam
    Malayappa Jeevanandam
  • FGFrank E. Gump
    Frank E. Gump
  • AHAllen I. Hyman
    Allen I. Hyman
  • RBRobert Burr
    Robert Burr
  • JKJohn M. Kinney
    John M. Kinney
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Abstract
Lipolysis was studied by measuring glycerol turnover (GTO) in injured and infected patients. GTO was elevated two to three times the normal values in five injured and four infected patients during D5W infusion. No correlation was found between GTO and plasma glycerol concentration in the two patient groups. GTO showed similar levels when measured during TPN in five injured and three infected patients. During TPN, plasma FFA levels remained unchanged in injured but decreased by 48% in septic patients. B-OH butyrate concentrations were high during D5W and dropped in both groups during TPN. Norepinephrine urinary output was high in both groups during D5W and TPN. 1) GTO was elevated two to three times the normal range in injury and infection; plasma glycerol concentration was not related to GTO. 2) In face of high catecholamine output, the insulin response to TPN did not inhibit TG breakdown but did decrease plasma ketone body concentrations.