Lipolysis in burned patients is stimulated by the β2-receptor for catecholamines

David Herndon, T. T. Nguyen, R. R. Wolfe, S. P. Maggi, G. Biolo, M. Muller, R. E. Barrow, R. A. Forse, P. Q. Bessey

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Objective: To determine if the cardiovascular effects of excessive catecholamines could be selectively blocked in severely burned patients without adversely affecting protein or fat kinetics. Design: Prospective cohort study. Setting: A large tertiary care referral center in Galveston, Tex. Patients: Sixteen patients with greater than 40% body surface area burns. Interventions: Patients were randomly selected to receive propranolol hydrochloride, a nonselective β1- and β2-blocker, or metoprolol tartrate, a selective β1-blocker. Main Outcome Measures: Heart rate; rate-pressure product; rate of appearance of urea, glucose, and leucine; and leucine oxidation were measured before and after selective or nonselective β- adrenergic blockade. Results: Propranolol and metoprolol caused a significant decrease in heart rate, from a mean (±SD) of 143±15 to 115±11 and from 147±17 to 120±9 beats per minute, respectively, during the 5-day study period. Neither the rate of appearance of urea nor the rate of urea production were significantly altered by propranolol or metoprolol therapy. Only propranolol produced a significant decrease (P<.05) in the rate of appearance of glycerol, from a mean (±SD) of 5.54±0.62 to 3.07±0.7 μmol/kg per minute. The rate of appearance of leucine, used as an index of total body protein catabolism, was not significantly altered by either β- blocker. Conclusions: Selective β1-adrenergic blockade did not reduce lipolysis; however, a β1- and β2-adrenergic blockade significantly reduced lipolysis. Thus, the increased lipolysis, characteristic of severely burned patients, is caused by stimulation of the β2-adrenergic receptors for catecholamines.

Original languageEnglish (US)
Pages (from-to)1301-1305
Number of pages5
JournalArchives of Surgery
Volume129
Issue number12
StatePublished - 1994

Fingerprint

Catecholamine Receptors
Lipolysis
Propranolol
Metoprolol
Leucine
Adrenergic Agents
Urea
Tertiary Care Centers
Catecholamines
Heart Rate
Body Surface Area
Burns
Glycerol
Adrenergic Receptors
Proteins
Cohort Studies
Fats
Outcome Assessment (Health Care)
Prospective Studies
Pressure

ASJC Scopus subject areas

  • Surgery

Cite this

Herndon, D., Nguyen, T. T., Wolfe, R. R., Maggi, S. P., Biolo, G., Muller, M., ... Bessey, P. Q. (1994). Lipolysis in burned patients is stimulated by the β2-receptor for catecholamines. Archives of Surgery, 129(12), 1301-1305.

Lipolysis in burned patients is stimulated by the β2-receptor for catecholamines. / Herndon, David; Nguyen, T. T.; Wolfe, R. R.; Maggi, S. P.; Biolo, G.; Muller, M.; Barrow, R. E.; Forse, R. A.; Bessey, P. Q.

In: Archives of Surgery, Vol. 129, No. 12, 1994, p. 1301-1305.

Research output: Contribution to journalArticle

Herndon, D, Nguyen, TT, Wolfe, RR, Maggi, SP, Biolo, G, Muller, M, Barrow, RE, Forse, RA & Bessey, PQ 1994, 'Lipolysis in burned patients is stimulated by the β2-receptor for catecholamines', Archives of Surgery, vol. 129, no. 12, pp. 1301-1305.
Herndon D, Nguyen TT, Wolfe RR, Maggi SP, Biolo G, Muller M et al. Lipolysis in burned patients is stimulated by the β2-receptor for catecholamines. Archives of Surgery. 1994;129(12):1301-1305.
Herndon, David ; Nguyen, T. T. ; Wolfe, R. R. ; Maggi, S. P. ; Biolo, G. ; Muller, M. ; Barrow, R. E. ; Forse, R. A. ; Bessey, P. Q. / Lipolysis in burned patients is stimulated by the β2-receptor for catecholamines. In: Archives of Surgery. 1994 ; Vol. 129, No. 12. pp. 1301-1305.
@article{0acbefbd99a541b7bcfb0e496ac5d81b,
title = "Lipolysis in burned patients is stimulated by the β2-receptor for catecholamines",
abstract = "Objective: To determine if the cardiovascular effects of excessive catecholamines could be selectively blocked in severely burned patients without adversely affecting protein or fat kinetics. Design: Prospective cohort study. Setting: A large tertiary care referral center in Galveston, Tex. Patients: Sixteen patients with greater than 40{\%} body surface area burns. Interventions: Patients were randomly selected to receive propranolol hydrochloride, a nonselective β1- and β2-blocker, or metoprolol tartrate, a selective β1-blocker. Main Outcome Measures: Heart rate; rate-pressure product; rate of appearance of urea, glucose, and leucine; and leucine oxidation were measured before and after selective or nonselective β- adrenergic blockade. Results: Propranolol and metoprolol caused a significant decrease in heart rate, from a mean (±SD) of 143±15 to 115±11 and from 147±17 to 120±9 beats per minute, respectively, during the 5-day study period. Neither the rate of appearance of urea nor the rate of urea production were significantly altered by propranolol or metoprolol therapy. Only propranolol produced a significant decrease (P<.05) in the rate of appearance of glycerol, from a mean (±SD) of 5.54±0.62 to 3.07±0.7 μmol/kg per minute. The rate of appearance of leucine, used as an index of total body protein catabolism, was not significantly altered by either β- blocker. Conclusions: Selective β1-adrenergic blockade did not reduce lipolysis; however, a β1- and β2-adrenergic blockade significantly reduced lipolysis. Thus, the increased lipolysis, characteristic of severely burned patients, is caused by stimulation of the β2-adrenergic receptors for catecholamines.",
author = "David Herndon and Nguyen, {T. T.} and Wolfe, {R. R.} and Maggi, {S. P.} and G. Biolo and M. Muller and Barrow, {R. E.} and Forse, {R. A.} and Bessey, {P. Q.}",
year = "1994",
language = "English (US)",
volume = "129",
pages = "1301--1305",
journal = "JAMA Surgery",
issn = "2168-6254",
publisher = "American Medical Association",
number = "12",

}

TY - JOUR

T1 - Lipolysis in burned patients is stimulated by the β2-receptor for catecholamines

AU - Herndon, David

AU - Nguyen, T. T.

AU - Wolfe, R. R.

AU - Maggi, S. P.

AU - Biolo, G.

AU - Muller, M.

AU - Barrow, R. E.

AU - Forse, R. A.

AU - Bessey, P. Q.

PY - 1994

Y1 - 1994

N2 - Objective: To determine if the cardiovascular effects of excessive catecholamines could be selectively blocked in severely burned patients without adversely affecting protein or fat kinetics. Design: Prospective cohort study. Setting: A large tertiary care referral center in Galveston, Tex. Patients: Sixteen patients with greater than 40% body surface area burns. Interventions: Patients were randomly selected to receive propranolol hydrochloride, a nonselective β1- and β2-blocker, or metoprolol tartrate, a selective β1-blocker. Main Outcome Measures: Heart rate; rate-pressure product; rate of appearance of urea, glucose, and leucine; and leucine oxidation were measured before and after selective or nonselective β- adrenergic blockade. Results: Propranolol and metoprolol caused a significant decrease in heart rate, from a mean (±SD) of 143±15 to 115±11 and from 147±17 to 120±9 beats per minute, respectively, during the 5-day study period. Neither the rate of appearance of urea nor the rate of urea production were significantly altered by propranolol or metoprolol therapy. Only propranolol produced a significant decrease (P<.05) in the rate of appearance of glycerol, from a mean (±SD) of 5.54±0.62 to 3.07±0.7 μmol/kg per minute. The rate of appearance of leucine, used as an index of total body protein catabolism, was not significantly altered by either β- blocker. Conclusions: Selective β1-adrenergic blockade did not reduce lipolysis; however, a β1- and β2-adrenergic blockade significantly reduced lipolysis. Thus, the increased lipolysis, characteristic of severely burned patients, is caused by stimulation of the β2-adrenergic receptors for catecholamines.

AB - Objective: To determine if the cardiovascular effects of excessive catecholamines could be selectively blocked in severely burned patients without adversely affecting protein or fat kinetics. Design: Prospective cohort study. Setting: A large tertiary care referral center in Galveston, Tex. Patients: Sixteen patients with greater than 40% body surface area burns. Interventions: Patients were randomly selected to receive propranolol hydrochloride, a nonselective β1- and β2-blocker, or metoprolol tartrate, a selective β1-blocker. Main Outcome Measures: Heart rate; rate-pressure product; rate of appearance of urea, glucose, and leucine; and leucine oxidation were measured before and after selective or nonselective β- adrenergic blockade. Results: Propranolol and metoprolol caused a significant decrease in heart rate, from a mean (±SD) of 143±15 to 115±11 and from 147±17 to 120±9 beats per minute, respectively, during the 5-day study period. Neither the rate of appearance of urea nor the rate of urea production were significantly altered by propranolol or metoprolol therapy. Only propranolol produced a significant decrease (P<.05) in the rate of appearance of glycerol, from a mean (±SD) of 5.54±0.62 to 3.07±0.7 μmol/kg per minute. The rate of appearance of leucine, used as an index of total body protein catabolism, was not significantly altered by either β- blocker. Conclusions: Selective β1-adrenergic blockade did not reduce lipolysis; however, a β1- and β2-adrenergic blockade significantly reduced lipolysis. Thus, the increased lipolysis, characteristic of severely burned patients, is caused by stimulation of the β2-adrenergic receptors for catecholamines.

UR - http://www.scopus.com/inward/record.url?scp=0027984430&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027984430&partnerID=8YFLogxK

M3 - Article

C2 - 7986160

AN - SCOPUS:0027984430

VL - 129

SP - 1301

EP - 1305

JO - JAMA Surgery

JF - JAMA Surgery

SN - 2168-6254

IS - 12

ER -