The Neurohumoral Response to Burn Injury in Patients Resuscitated with Hypertonic Saline

Crum, Ralph; Bobrow, Bentley J.; Shackford, Steven R.; Hansbrough, John F.; Brown, Marvin R.

doi:10.1097/00005373-198808000-00008

Cited by 29 publications

(16 citation statements)

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“…Burn injury has been shown to elevate epinephrine and norepinephrine levels (Crum et al 1988) as does cold exposure (Nakamoto 1990). In the present study, we did not measure epinephrine or norepinephrine levels in the stressed animals, however, Wahl and his coworkers demonstrated that anesthesia or exposure to cold increased 18 FDG uptake in BAT of rats 14 fold or 4.9 fold in rats, compared to unstimulated controls (Tatsumi et al 2004).…”

Section: Discussionmentioning

confidence: 99%

Effects of burn injury, cold stress and cutaneous wound injury on the morphology and energy metabolism of murine brown adipose tissue (BAT) in vivo

et al. 2011

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Aims Cold stress has been shown to produce dramatic increases in 2-fluoro-2-deoxy-D-Glucose (18FDG) accumulation by brown adipose tissue (BAT) in rodents. However, neither the effects of other types of stress on 18FDG accumulation nor the effects of stressors on the accumulation of tracers of other aspects of energy metabolism have been evaluated. In this report we studied the effects of cold stress, burn injury, and cutaneous wounds on murine BAT at the macroscopic, microscopic, and metabolic level. Main Methods Glucose metabolism was studied with 18FDG, fatty acid accumulation was evaluated with trans-9(RS)-18F-fluoro-3,4(RS,RS)- methyleneheptadecanoic acid (FCPHA) and tricarboxcylic acid cycle (TCA) activity was evaluated with 3H acetate. Key Findings All three stressors produced dramatic changes in BAT at the macroscopic and microscopic level. Macroscopically, BAT from the stressed animals appeared to be a much darker brown in color. Microscopically BAT of stressed animals demonstrated significantly fewer lipid droplets and an overall decrease in lipid content. Accumulation of 18FDG by BAT was significantly (P <0.01) increased by all 3 treatments (Cold: ∼16 fold, burn ∼7 Fold and cutaneous wound ∼14 fold) whereas uptake of FDG by white fat was unchanged. This effect was also demonstrated non- invasively by μPET imaging. Although less prominent than with 18FDG, BAT uptake of FCPHA and acetate were also significantly increased by all three treatments. These findings suggest that in addition to cold stress, burn injury and cutaneous wounds produce BAT activation in mice. Significance This study demonstrates brown fat activated by several stressors leads to increased uptake of various substrates.

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Section: Discussionmentioning

confidence: 99%

Effects of burn injury, cold stress and cutaneous wound injury on the morphology and energy metabolism of murine brown adipose tissue (BAT) in vivo

et al. 2011

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“…It is well established that burn injuries lead to a rapid and pronounced stress response with significantly increased plasma concentrations of endogenous arginine vasopressin and catecholamines (31–33). Furthermore, vasopressin and adrenergic receptors are known to undergo agonist induced internalization (34,35).…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Responsiveness to Vasopressin and α1-Adrenergic Receptor Agonists After Burn Injury

Evans

Vana

LaPorte

et al. 2017

Journal of Burn Care & Research

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Objective The effects of burn injury on cardiovascular responsiveness to vasoactive agents are not well understood. The aims of the present study were to determine whether burn injury alters cardiovascular reactivity to vasoactive drugs in vivo and intrinsic function of isolated mesenteric resistance arteries. Methods Anesthetized Sprague-Dawley rats were subjected to sham procedure or 30% total body surface area dorsal scald burn, followed by crystalloid resuscitation (Parkland Formula). At 24h, 72h, 96h, and 168h post-burn rats were re-anesthetized and the mean arterial blood pressure (MAP) responses to various doses of the α1-adrenergic receptor agonist phenylephrine and arginine vasopressin were tested. Mesenteric arteries were harvested from uninjured animals and at 24h and 168h post-burn. The responsiveness of arteries to phenylephrine and arginine vasopressin was tested by pressure myography. Dose response curves were generated and EC50 concentrations, Hill slopes and maximal effects were compared. Results The potency of phenylephrine to increase MAP was reduced 2-fold 24h post-burn (p<0.05 vs. sham) and gradually normalized at later time points. The reactivity of isolated arteries to phenylephrine was not significantly altered after burns. The potency of arginine vasopressin to increase MAP and to constrict isolated arteries was increased 2-3-fold at 24h post-burn (p<0.05) and normalized at later time points. Conclusions Burn injury differentially regulates vasopressor and blood pressure effects of α-adrenergic and vasopressin receptor agonists. Intrinsic vasopressin receptor reactivity of resistance arteries is sensitized early after burns. These findings will help to optimize resuscitation strategies and vasopressor use in difficult to resuscitate burn patients.

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“…The mechanism(s) for activation of BAT thermogenesis are assumed to be through the sympathetic nervous system 24 . Burn injury has been shown to elevate epinephrine and norepinephrine levels 25 . We did not measure catecholamine levels in the burned mice in this experiment.…”

Section: Discussionmentioning

confidence: 99%

Single Hind Limb Burn Injury to Mice Alters Nuclear Factor-κB Expression and [18F] 2-Fluoro-2-Deoxy-D-Glucose Uptake

Carter

Hamrahi

Paul

et al. 2014

Journal of Burn Care & Research

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Burn trauma to the extremities can produce marked systemic effects in mice1, 6, 7. Burn injury to the dorsal surface of mice is also associated with changes in glucose metabolism (18FDG uptake) by brown adipose tissue (BAT) and NF-κB activity in a number of tissues including skeletal muscle. This study examined the effect of a single hindlimb burn in mice on 18FDG uptake by in vivo, NF-κB activity in vivo, and blood flow determined by laser Doppler techniques. Male mice NF-κB luciferase reporter mice (28 grams- 30 grams, male) were anesthetized, both legs were shaven, and the right leg was subjected to scald injury by immersion in 90°C water for 5 seconds. Sham treated animals were used as controls. Each burned and sham mouse was resuscitated with saline (2 ml, IP). The individual animals were placed in wire bottom cages with no food and free access to water. 24 hrs later, the animals were imaged with Laser Doppler for measurements of blood flow in the hind limb. The animals were then injected unanesthetized with 50 µCi of FDG or luciferin (1.0 mg), I.V. via tail vein. Five minutes after luciferin injection, NF-kB mice were studied by bioluminescence imaging with a CCD camera. One hour after 18FDG injection the animals were euthanized with carbon dioxide overdose and 18FDG biodistribution was measured. Tissues were also analyzed for NF-κB luciferase activity. The scalding procedure used here produced a full thickness burn injury to the leg with sharp margins. 18FDG uptake by the burned leg was lower than in the contralateral limb. Similarly luciferase activity and blood flow in the burned leg were lower than in the contralateral leg. 18FDG uptake by BAT and heart was increased, while brain was decreased. In conclusion, the present study suggests that burn injury to a single leg reduced 18FDG uptake by skeletal muscle but increased 18FDG uptake by BAT. The injury to the leg reduced NF-κB expression as compared to the contralateral leg and the uninjured skeletal muscle of the sham, but activated NF-κB expression in a number of other organs. These findings are consistent with the hypothesis that burn trauma to the extremities can produce marked systemic effects, including activation of NF-κB expression and activation of 18FDG uptake by BAT.

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The Neurohumoral Response to Burn Injury in Patients Resuscitated with Hypertonic Saline

Cited by 29 publications

References 0 publications

Effects of burn injury, cold stress and cutaneous wound injury on the morphology and energy metabolism of murine brown adipose tissue (BAT) in vivo

Effects of burn injury, cold stress and cutaneous wound injury on the morphology and energy metabolism of murine brown adipose tissue (BAT) in vivo

Cardiovascular Responsiveness to Vasopressin and α1-Adrenergic Receptor Agonists After Burn Injury

Single Hind Limb Burn Injury to Mice Alters Nuclear Factor-κB Expression and [18F] 2-Fluoro-2-Deoxy-D-Glucose Uptake

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