The significance of altered gluconeogenesis in surgical catabolism.
The significance of altered gluconeogenesis in surgical catabolism.
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糖异生改变在手术分解代谢中的重要性。
DOI：
10.1097/00005373-197508000-00013
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发表时间：
1975
期刊：
影响因子：
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通讯作者：
J. Kinney
中科院分区：
文献类型：
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作者：
F. Gump;C. Long;J. Geiger;J. Kinney
由国家普通医学科学研究所资助，GM 14546-08。在美国创伤外科协会第三十四届年会上发表，1974年10月17日至19日，弗吉尼亚州温泉市。转载地址：Frank E. Gump，MD，De-这些患者进行了择期手术而不是创伤性损伤，但被选入研究是因为他们发生了严重的脓毒性并发症，导致发热，体重减轻和负氮平衡。在研究前一天午夜终止所有热量摄入，包括IV葡萄糖。用7号Goodale-Lubin导管插入暴露的右肘前静脉进行肝静脉插管。在X线透视控制下，将导管推进至较大的右肝静脉。楔入导管头端，然后撤回2-4 cm，直至获得血液自由流动。将动脉针插入股动脉。通过使用吲哚菁绿绿色染料（4）的连续输注技术（3）测量估计的内脏血流量（ESBF）。在5 mg预充剂量后，以0.3 mg/min/M* BSA的速率输注染料。导管就位后，将患者置于头罩中，连续测量氧气消耗量和一氧化碳产生量（19）。最后，同时获得动脉和肝静脉血液样本，用于血糖、血尿素氮、20种氨基酸和吲哚菁绿色浓度。在半小时研究期间，在0、15和30分钟采集样本。认为患者在此期间处于稳态。根据三份动脉和肝静脉样本的平均值计算葡萄糖、尿素和吲哚菁绿色的动脉-肝静脉差异，但仅分析了一份动脉和一份肝静脉样本的20种氨基酸。然后测定任何底物的摄取或释放，
Supported by the National Institute of General Medical Sciences, Grant GM 14546-08. Presented at the Thirty-fourth Annual Session of the American Association for the Surgery of Trauma, 17–19 October 1974, Hot Springs, Virginia. Address for reprints: Frank E. Gump, MD, De-these patients had elective operations rather than traumatic injuries, but were selected for the study because they developed major septic complications resulting in fever, weight loss, and a negative nitrogen balance. All caloric intake including IV glucose was terminated at midnight on the day before the study. Hepatic vein catheterization was carried out with a No. 7 Goodale-Lubin catheter in-serted into an exposed right antecubital vein. The catheter was advanced to a large right hepatic vein under fluoroscopic control. The catheter tip was wedged and then withdrawn 2–4 cm until free flow of blood was obtained. An arterial needle was inserted into the femoral artery. Estimated splanchnic blood flow (ESBF) was measured by the continuous infusion technique (3) with indocyanine green dye (4), The dye was infused at a rate of 0.3 mg/min/M* BSA follow-ing a 5-mg priming dose.After the catheters were in place the patient was placed in a head canopy for continuous measurement of oxygen consumption and CO, production (19). Finally, simultaneous arterial and hepatic venous blood samples were ob-tained for blood glucose, blood urea nitrogen, 20 amino acids, and indocyanine green concentration. Samples were drawn at zero, 15, and 30 minutes during the half-hour study period. The patients were considered to be in a steady state during this time period. Arterio-hepatic venous differences for glucose, urea, and indocyanine green were calculated from the means of the three arterial and hepatic venous samples, but only one arterial and one hepatic venous sample was analyzed for the 20 amino acids. The uptake or release of any substrate was then