Objective To investigate the hypothesis that the stimulation of pyruva
te oxidation by dichloroacetate (DCA) administration would increase th
e level of intramuscular glutamine in severely burned patients Summary
Background Data The level of intramuscular glutamine decreases in res
ponse to severe injury, and the rate of intramuscular glycolysis and p
yruvate oxidation is elevated. Intramuscular glutamine concentrations
have been correlated to muscle protein synthesis. Methods Six studies
were conducted on five patients with burns >40% total body surface are
a. Patients were studied in the fed state during an 8-hour stable isot
ope infusion. After 5 hours, DCA (30 mg/kg) was administered for 30 mi
nutes. Results analysis of muscle biopsy samples taken at 5 and 8 hour
s of the study revealed a 32% increase in intracellular glutamine leve
ls after DCA administration. Increased intracellular glutamine concent
rations did not effect skeletal muscle protein synthesis as determined
by a three-pool arteriovenous model or by the direct incorporation of
isotope into skeletal muscle protein. DCA administration resulted in
a decrease in plasma lactate but no change in alanine de novo synthesi
s or intracellular concentration. Conclusions These results suggest th
at acute DCA administration can increase intramuscular glutamine conce
ntration, but that this acute elevation does not affect muscle protein
metabolism.