DERANGEMENTS IN PERIPHERAL GLUCOSE AND OXYGEN UTILIZATION INDUCED BY CATABOLIC HORMONES

Objective: To assess if the derangements in peripheral glucose, lactat e, and oxygen utilization that are observed in severely injured patien ts are due to the hormonal response to injury or are related to the ex tent of the wound. Design: Comparison study. Interventions: The catabo lic hormones epinephrine, cortisol, and glucagon were infused simultan eously into the femoral artery of six healthy volunteers, thus simulat ing the hormonal milieu associated with severe trauma in an uninjured leg. Setting: Clinical research center at a university-affiliated hosp ital. Patients: Young, adult males deemed healthy by screening medical history, physical examination, and blood chemistries. Measurements an d Main Results: Substrate net balance and indirect calorimetry measure ments were performed before and then at the completion of 2 hrs of cat abolic hormone infusion. Catabolic hormones elicited significant incre ases in leg glucose uptake and oxidation, and an increased net efflux from the leg of lactate and alanine. While leg oxygen delivery also in creased, catabolic hormones failed to alter peripheral oxygen consumpt ion. Conclusions: Catabolic hormones can elicit a similar peripheral m etabolic response in an uninjured leg as that reported previously by W ilmore et al. in severely burned extremities. This finding suggests th at the hormonal milieu associated with severe injury is influential in regulating peripheral glucose and oxygen utilization and that wound i nflammation is not an essential component of this response.