MANIPULATION OF THE INFLAMMATORY RESPONSE TO BURN INJURY

Background: Burn injury is characterized by hypermetabolism and protei n catabolism. Endotoxin, derived from either wound or gut, may partici pate in this response, Methods: Eleven seriously burned patients were treated with the endotoxin-binding agent polymyxin B and underwent par titional calorimetry and nitrogen balance studies, The data from these s patients were compared with data from 28 contemporary, similarly bur ned patients who did not receive polymyxin B. Results: Elevated levels of circulating endotoxin were not consistently detected in either gro up, Interleukin-6 was elevated and correlated with rectal temperature and nitrogen excretion in both groups, Administration of polymyxin B p roduced no change in metabolic rate but produced a significantly more positive nitrogen balance and was associated with a prompt reduction i n interleukin-6 levels, Conclusions: These data support the hypothesis that endotoxin plays a role in the postburn protein catabolism but no t in the hypermetabolic response, This protein catabolic response is s tatistically associated with circulating interleukin-6 levels, suggest ing a possible role for interleukin-6 in postinjury protein wasting.