Open AccessMetabolic Changes in Patients Severely Affected by Tetanus
Author(s) -
Atsushi Hiraide,
M Katayama,
Hisashi Sugimoto,
Toshiharu Yoshioka,
Tsuneaki Sugimoto
Publication year - 1991
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-199101000-00011
Subject(s) - medicine , excretion , endocrinology , blood pressure , glucagon , urine , catabolism , hormone , urinary system , urea , catecholamine , protein catabolism , hydrocortisone , metabolism , amino acid , biochemistry , chemistry , organic chemistry
Metabolic changes in six severely affected tetanus patients suffering from characteristic labile hypertension (maximum systolic blood pressure greater than 200 mmHG, maximum diurnal change in systolic pressure greater than 100 mmHg) were investigated. Daily urinary excretion of urea nitrogen increased gradually from the onset of opisthotonus, reached a peak value (10.4 to 15.4 g/m2) in 8 to 20 days, and decreased subsequently. Average cumulative excretion in 30 days reached 239.6 +/- 32.7 g/m2. Urine catecholamine excretion was elevated in each patient and remained elevated during this period. Plasma cortisol and glucagon concentrations were not increased markedly except in a case complicated other systemic bacterial infection. Increased protein catabolism in these patients could not be explained by the metabolic effects of 'stressed hormones' alone, and neurologic factors must be considered.