Jeschke, Marc G. and Klein, Dagmar and Herndon, David N. (2004) Insulin treatment improves the systemic inflammatory reaction to severe trauma. ANNALS OF SURGERY, 239 (4). pp. 553-560. ISSN 0003-4932,
Full text not available from this repository. (Request a copy)Abstract
Objective: Determine the effect of insulin on the systemic inflammatory response, pro- and anti-inflammatory cytokines and hepatic acute-phase-response in severely burned pediatric patients. Summary Background Data: The systemic inflammatory and hepatic acute-phase-response contribute to hypermetabolism, multi-organ failure, and mortality. Insulin has been recently shown to decrease mortality and to prevent the incidence of multi-organ failure in critically ill patients; however, the underlying mechanisms have not been defined. Methods: Thirteen thermally injured children received insulin to maintain blood glucose at a range from 120 to 180 mg/dl, 15 children received no insulin with blood glucose levels also at range from 120 to 180 mg/dl and served as controls. Our outcome measures encompassed the effect of insulin on pro-inflammatory mediators, the hepatic acute-phase-response, fat, and the IGF-I system. Results: Insulin administration decreased pro-inflammatory cytokines and proteins, while increasing constitutive-hepatic proteins (P < 0.05). Burned children receiving insulin required significantly less albumin substitution to maintain normal levels compared with control (P < 0.05). Insulin decreased free fatty acids and serum triglycerides when compared with controls (P < 0.05). Serum IGF-I and IGFBP-3 significantly increased with insulin administration (P < 0.05). Conclusion: Insulin attenuates the inflammatory response by decreasing the pro-inflammatory and increasing the anti-inflammatory cascade, thus restoring systemic homeostasis, which has been shown critical for organ function and survival in critically ill patients.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | GROWTH-FACTOR-I; ACUTE-PHASE RESPONSE; CRITICALLY-ILL; TRIGLYCERIDE SECRETION; INCREASED MORTALITY; GENE-TRANSCRIPTION; PROTEIN-SYNTHESIS; HORMONE TREATMENT; CRITICAL ILLNESS; BURN PATIENTS; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 21 Jul 2021 12:23 |
| Last Modified: | 21 Jul 2021 12:23 |
| URI: | https://pred.uni-regensburg.de/id/eprint/37761 |
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