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The effect of hypermetabolism induced by burn trauma on the ethanol-oxidizing capacity of the liver
Linköping University, Department of Medicine and Care, Anaesthesiology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Biomedicine and Surgery, Plastic Surgery, Hand Surgery and Burns. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Care, Anaesthesiology. Linköping University, Faculty of Health Sciences.
National Laboratory of Forensic Chemistry, Linköping, Sweden.
1999 (English)In: Critical Care Medicine, ISSN 0090-3493, E-ISSN 1530-0293, Vol. 27, no 12, 2622-2625 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To study the rate of elimination of ethanol after a major burn trauma.

Design: Prospective, controlled study.

Setting: National burns unit in a Swedish university hospital.

Patients and Subjects: Eight consecutive patients suffering from 18%-72% total burned surface area and nine healthy male control subjects.

Interventions: The patients received ethanol, 0.35-0.60 g/kg body weight intravenously, during 1 hr. This was repeated daily during the first week postburn. The control subjects received the same amount of ethanol once.

Measurements and Main Results: Blood samples were drawn at 20- to 30-min intervals during 5 hrs after the start of the infusion. Serum ethanol was determined by headspace gas chromatography. The rate of elimination of ethanol was calculated from the concentration time profile. In the control subjects, the median elimination rate was 0.074 g/kg/hr (range, 0.059-0.083 g/kg/hr). In the patients, it was already 0.138 g/kg/hr (range, 0.111-0.201 g/kg/hr) on the first day; this increased even further over the following 6 days, reaching 0.183 g/kg/hr (range, 0.150-0.218 g/kg/hr) on the seventh day.

Conclusions: Ethanol elimination is augmented postburn. A more effective reoxidation of reduced nicotinamide adenine dinucleotide seems the most likely explanation for the increased rate of ethanol elimination in these hypermetabolic trauma patients. This finding suggests that the oxidative capacity of the liver may be assessed by studying the rate of ethanol elimination in burn victims.

Place, publisher, year, edition, pages
1999. Vol. 27, no 12, 2622-2625 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-25135Local ID: 9568OAI: diva2:245461
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2012-08-09Bibliographically approved
In thesis
1. Water physiology in burn victims
Open this publication in new window or tab >>Water physiology in burn victims
2000 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Patients who sustain a burn injury of more than 20 - 30 % TBSA will, if untreated, develop burn shock within a couple of hours. Flcid is lost fi·om the vascular compartment due to suction from the interstitium of the wound and due to a generalised increase in vascular permeability. To prevent bum shock intravenous fluids are given during the first two days after a bum in order to ensure adequate organ perfusion. Although organ perfusion will be improved when blood volume is restored, the fluid provided will add to the continuing leak into the tissues. With fluid treatment the patient survives the acute stage, but the resulting oedema interferes with the healing of the burn wound and partially damaged skin may be further compromised.

To describe, follow and understand the development of the general oedema in burn injured patients we used four different techniques. Ethanol dilution was used for measurement of total body water (TBW), iohexol dilution in order to estimate extracellular volume (ECV), bioimpedance analysis (BIA) to register TBW as well as electrical membrane properties and the impression method (IM) for the measurement of visco-elastic properties in non-burned tissues. In order to further examine the non-invasive techniques (BIA and IM) these were used in patients subjected to haemodialysis.

The excess fluid was found to be accumulated in the extracellular space. Interesting alterations in the visco-clastic properties of the skin and cellular electrical membrane properties could also be detected. These alterations were not related to the actual tluid volume in the tissues. Instead, they were related to changes in the fluid equilibrium of the tissues. Still, one week postbum an excess of tissue fluid, altered cellular electrical membrane properties and changed visco-elastic properties of the skin remained.

Albumin supplementation did not influence the amount or distribution of the excess tissue fluid, measured with dilution techniques.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2000. 61 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 633
Total body water, Extracellular fluid, Burn, Bioelectrical impedance, Oedema, Extracellular matrix
National Category
Medical and Health Sciences
urn:nbn:se:liu:diva-27560 (URN)12222 (Local ID)91-7219-734-X (ISBN)12222 (Archive number)12222 (OAI)
Public defence
2000-05-27, Berzeliussalen, Universitetssjukhuset, Linköping, 08:30 (Swedish)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2015-06-09Bibliographically approved

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Zdolsek, Hans JoachimSjöberg, FolkeLisander, BjörnJones, Wayne A.
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