Effects of early enteral arginine supplementation on resuscitation of severe burn patients

Yan, Hong; Peng, Xi; Huang, Yuesheng; Zhao, Mingyue; Li, Fangyong; Wang, Pei

doi:10.1016/j.burns.2006.06.012

Cited by 45 publications

(19 citation statements)

References 9 publications

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“…Restoration of tissue perfusion is important to wound healing and tissue survival under a range of conditions. 38,39 L-arginine, the precursor for NO production, has been reported to be useful in resuscitation of burn wound patients 40 and in increasing survival and reperfusion of ischemic tissues. 41,42 NO has also been shown to enhance ischemic tissue survival.…”

Section: Discussionmentioning

confidence: 99%

Blockade of Thrombospondin-1-CD47 Interactions Prevents Necrosis of Full Thickness Skin Grafts

Isenberg¹,

Pappan²,

Romeo³

et al. 2008

Annals of Surgery

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Section: Discussionmentioning

confidence: 99%

Blockade of Thrombospondin-1-CD47 Interactions Prevents Necrosis of Full Thickness Skin Grafts

Isenberg¹,

Pappan²,

Romeo³

et al. 2008

Annals of Surgery

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“…The mechanism of this response is likely mediated by reversing the paucity of available arginine in the burn wound caused by exaggerated arginase production by MDSCs, which subsequently reduces P. aeruginosa motility. l -Arg is already frequently used as a dietary supplement to resuscitate burned individuals with cutaneous and lung injuries (32–36). Therefore, the development of an arginine-based topical treatment has the potential to both aid in patient recovery as well as reduce the spread of aggressive multidrug-resistant bacterial strains, like those of P. aeruginosa .…”

Section: Discussionmentioning

confidence: 99%

Arginine Is a Critical Substrate for the Pathogenesis ofPseudomonas aeruginosain Burn Wound Infections

Everett

Turner

Cai

et al. 2017

mBio

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Environmental conditions affect bacterial behavior and can greatly influence the course of an infection. However, the environmental cues that elicit bacterial responses in specific infection sites are relatively unknown. Pseudomonas aeruginosa is ubiquitous in nature and typically innocuous. However, it is also one of the most prevalent causes of fatal sepsis in burn wound patients. The aim of this study was to determine the impact of environmental factors, specifically the availability of arginine, on the pathogenesis of P. aeruginosa in burn wound infections. Comparison of burned versus noninjured tissue revealed that l-arginine (l-Arg) was significantly depleted in burn wounds as a consequence of elevated arginase produced by myeloid-derived suppressor cells. We also observed that l-Arg was a potent chemoattractant for P. aeruginosa, and while low concentrations of l-Arg increased P. aeruginosa’s swimming motility, high concentrations resulted in diminished swimming. Based on these observations, we tested whether the administration of exogenous l-Arg into the burn wound could attenuate the virulence of P. aeruginosa in thermally injured mice. Administration of l-Arg resulted in decreased P. aeruginosa spread and sepsis and increased animal survival. Taken together, these data demonstrate that the availability of environmental arginine greatly influences the virulence of P. aeruginosa in vivo and may represent a promising phenotype-modulating tool for future therapeutic avenues.

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“…Once bowel sound resumes, the amount of food can be increased. Using immunoregulatory nutrients such as oral glutamine, L-arginine and dietary fiber promoted post-burn repair of GI mucosa, maintained GI barrier function, and reduced translocation of enterogenic bacteria and endotoxins [21,22] . The microenvironment for med by GI resident bacteria forms an ecologic barrier in the intestinal lumen, preventing intestinal pathologic bacteria from colonization and substantial proliferation [23] .…”

Section: Discussionmentioning

confidence: 99%

Prevention and treatment of gastrointestinal dysfunction following severe burns: A summary of recent 30-year clinical experience

Xiao¹,

Zhu²,

Xia³

et al. 2008

WJG

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(P < 0.05 or P < 0.01), and the occurrence of stress ulcer was also significantly lower than that in stage 2 patients (P < 0.05). CONCLUSION: Comprehensive fluid resuscitation, early excision of necrotic tissue, staged food ingestion, and administration of specific nutrients are essential strategies for preventing gastrointestinal complications and lowering mortality in severely burned patients. INTRODUCTIONGastrointestinal dysfunction is a common complication of severe burns. Injury to GI function, especially to GI barrier function, is an important initiator as well as a stimulator for occurrence of systemic inflammatory response syndrome (SIRS), sepsis and multiple organ dysfunction syndrome (MODS) following severe burns [1] . With the deeper understanding of GI function and changes in the stereotype of clinical treatment in recent 30 years, a series of new therapies including fluid resuscitation, early escharectomy, continuous renal replacement therapy, and use of glutamine and growth factor has been adopted in the treatment of severe burns [2,3] . Although animal experiments have shown that these new therapies do play a positive role in the prevention and treatment of GI dysfunction following severe burns, there has been a lack of convincing clinical Abstract AIM: To sum up the recent 30-year experience in the prevention and treatment of gastrointestinal dysfunction in severe burn patients, and propose practicable guidelines for the prevention and treatment of gastrointestinal (GI) dysfunction. METHODS: From 1980 to 2007, a total of 219 patients with large area and extraordinarily large area burns (LAB) were admitted, who were classified into three stages according the therapeutic protocols used at the time: Stage 1 from 1980 to 1989, stage 2 from 1990 to 1995, and stage 3 from 1996 to 2007. The occurrence and mortality of GI dysfunction in patients of the three stages were calculated and the main causes were analyzed. RESULTS: The occurrence of stress ulcer in patients with LAB was 8.6% in stage 1, which was significantly lower than that in stage 1 (P < 0.05). No massive hemorrhage from severe stress ulcer and enterogenic infections occurred in stages 2 and 3. The occurrence of abdominal distension and stress ulcer and the mortality in stage 3 patients with extraordinarily LAB was 7.1%, 21.4% and 28.5%, respectively, which were significantly lower than those in stage 1 patients

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Effects of early enteral arginine supplementation on resuscitation of severe burn patients

Cited by 45 publications

References 9 publications

Blockade of Thrombospondin-1-CD47 Interactions Prevents Necrosis of Full Thickness Skin Grafts

Blockade of Thrombospondin-1-CD47 Interactions Prevents Necrosis of Full Thickness Skin Grafts

Arginine Is a Critical Substrate for the Pathogenesis ofPseudomonas aeruginosain Burn Wound Infections

Prevention and treatment of gastrointestinal dysfunction following severe burns: A summary of recent 30-year clinical experience

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