Influence of glucose kinetics on plasma lactate concentration and energy expenditure in severely burned patients

Dennis Gore, A. Ferrando, J. Barnett, Steven Wolf, M. Desai, David Herndon, C. Goodwin, R. R. Wolfe, J. W. Davis, J. H. Siegel, F. Luchette, R. J. Mullins, D. C. Gore

Research output: Contribution to journalArticle

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Abstract

Background: In critically ill patients, elevation in the plasma lactate concentration has traditionally been interpreted as indicating a deficiency in oxygen availability and is often an impetus to increase oxygen delivery clinically. However, another possible basis for increased lactate concentrations may be simply a mass effect from increased pyruvate availability (i.e., accelerated glycolysis). Methods: In six hypermetabolic burned patients, the rates of glucose production and oxidation were quantified using a tracer infusion of 6,6 d2 glucose combined with indirect calorimetry. Measurements were obtained after a 9-hour fast and after a 3-hour infusion of unlabeled glucose at 30 μmol/kg/min. No patient was overtly septic, hypoxic, or hypovolemic. Results: The infusion of glucose significantly increased the arterial glucose concentration and rate of glucose oxidation, with a corresponding increase in the arterial plasma concentration of lactate and pyruvate. Resting energy expenditure and oxygen consumption were not affected by the infusion of glucose. Conclusions: These findings show that elevations in plasma lactate in severely injured patients may, in part, be related to increases in glucose flux and not entirely a reflection of any deficit in oxygen availability. Such findings highlight a potential pitfall for interpreting plasma lactate concentrations as an index of tissue oxygen availability in hypermetabolic patients.

Original languageEnglish (US)
Pages (from-to)673-678
Number of pages6
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume49
Issue number4
StatePublished - 2000

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Energy Metabolism
Lactic Acid
Glucose
Oxygen
Pyruvic Acid
Indirect Calorimetry
Hypovolemia
Glycolysis
Critical Illness
Oxygen Consumption

Keywords

  • Hypermetabolism
  • Oxygen availability
  • Pyruvate

ASJC Scopus subject areas

  • Surgery

Cite this

Influence of glucose kinetics on plasma lactate concentration and energy expenditure in severely burned patients. / Gore, Dennis; Ferrando, A.; Barnett, J.; Wolf, Steven; Desai, M.; Herndon, David; Goodwin, C.; Wolfe, R. R.; Davis, J. W.; Siegel, J. H.; Luchette, F.; Mullins, R. J.; Gore, D. C.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 49, No. 4, 2000, p. 673-678.

Research output: Contribution to journalArticle

Gore, D, Ferrando, A, Barnett, J, Wolf, S, Desai, M, Herndon, D, Goodwin, C, Wolfe, RR, Davis, JW, Siegel, JH, Luchette, F, Mullins, RJ & Gore, DC 2000, 'Influence of glucose kinetics on plasma lactate concentration and energy expenditure in severely burned patients', Journal of Trauma - Injury, Infection and Critical Care, vol. 49, no. 4, pp. 673-678.
Gore, Dennis ; Ferrando, A. ; Barnett, J. ; Wolf, Steven ; Desai, M. ; Herndon, David ; Goodwin, C. ; Wolfe, R. R. ; Davis, J. W. ; Siegel, J. H. ; Luchette, F. ; Mullins, R. J. ; Gore, D. C. / Influence of glucose kinetics on plasma lactate concentration and energy expenditure in severely burned patients. In: Journal of Trauma - Injury, Infection and Critical Care. 2000 ; Vol. 49, No. 4. pp. 673-678.
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AU - Ferrando, A.

AU - Barnett, J.

AU - Wolf, Steven

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AU - Herndon, David

AU - Goodwin, C.

AU - Wolfe, R. R.

AU - Davis, J. W.

AU - Siegel, J. H.

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AU - Mullins, R. J.

AU - Gore, D. C.

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