Burn encephalopathy and syndrome of hypermetabolism-hypercatabolism: is there an interrelation?

Authors

  • Олена Юріївна Сорокіна State Establishment “Dnepropetrovsk Medical Academy of health ministry of Ukraine” 9 Dzerginskogo str., Dnepropetrovsk, Ukraine, 49044, Ukraine http://orcid.org/0000-0002-7374-0507
  • Тетяна Олександрівна Буряк State Establishment “Dnepropetrovsk Medical Academy of health ministry of Ukraine” 9 Dzerginskogo str., Dnepropetrovsk, Ukraine, 49044, Ukraine http://orcid.org/0000-0001-6473-0887
  • Евеліна Василівна Сотнікова KE "Dnepropetrovsk specialized clinical center of mother and child named prof. M. F. Rudnev 26 Pushkin ave., Dnepropetrovsk, Ukraine, 49006, Ukraine
  • Ніна Іванівна Литвиненко KE "Dnepropetrovsk specialized clinical center of mother and child named prof. M. F. Rudnev 26 Pushkin ave., Dnepropetrovsk, Ukraine, 49006, Ukraine

DOI:

https://doi.org/10.15587/2313-8416.2015.53871

Keywords:

burn trauma, burn encephalopathy, cortisol, hyperglycemia, delirium, insomnia, cognitive dysfunction

Abstract

Aim: To define an influence of hypermetabolism-hypercatabolism syndrome on the burn encephalopathy development on the base of study of metabolic changes on the background of an acute period of burn disease.  

Materials and methods: there were examined 104 patients separated in 2 groups depending on heaviness of injury. There were defined the levels of cortisol, neurospecific enolase (NSE), glucose and blood protein. There were assessed memory, thinking and psychological state of patients.

Results: At admission to hospital the cortisol level in patients of 1 and 2 groups was 270,5±29,2 ng/ml and 330,3±17,4 ng/ml, glucose level - 6,0±0,4 mmol/l and 7,7±0,5 mmol/l in 1 and 2 groups respectively. The protein level of blood maximally decreased at 3 day and was 53,6±1,1 g/l in patients of the 1 group and 48,9±1,1 g/l in patients of the 2 group. An increase of cortisol level depended on heaviness of thermal trauma.  There was defined correlation between the levels of cortisol and neuron specific enolase in patients of the 1 group at 3 day (R=0.638, p=0.006), in patients of the 2 group at 7 day (R=0.488, p=0.002). In patients of the 1 group sleep disorder and delirium development did not depended on the level of metabolic changes. At the 7 day there was defined correlative connection between cortisol level and memory (R=-0,681, p=0,071) and thinking (R=-0,520, p=0,038). In patients of the 2 group cortisol level at 1 day determined the memory and thinking disorders to the septic-toxemia stage.  Sleep disorder correlated with expressed hypoproteinomia at 3 day (R=-0,483, p=0,001). The delirium development was caused with an increase of blood serum cortisol at 1 day after thermal trauma (R=0,467, p=0,058).

Conclusion: The one of mechanisms of nerve tissue injury was the development of metabolic changes caused by stress on the background of heavy thermal trauma. The dynamics of cortisol level to the burn shock stage corresponded with the changes of neurospecific enolase level of blood serum as a marker of the nerve tissue injury

Author Biographies

Олена Юріївна Сорокіна, State Establishment “Dnepropetrovsk Medical Academy of health ministry of Ukraine” 9 Dzerginskogo str., Dnepropetrovsk, Ukraine, 49044

Professor

Division of Anesthesiology, Intensive Therapy and Critical Care Medicine

Faculty of postgraduate education

Тетяна Олександрівна Буряк, State Establishment “Dnepropetrovsk Medical Academy of health ministry of Ukraine” 9 Dzerginskogo str., Dnepropetrovsk, Ukraine, 49044

Assistant of Professor

Division of Anesthesiology, Intensive Therapy and Critical Care Medicine

Faculty of postgraduate education

Евеліна Василівна Сотнікова, KE "Dnepropetrovsk specialized clinical center of mother and child named prof. M. F. Rudnev 26 Pushkin ave., Dnepropetrovsk, Ukraine, 49006

Anesthesiologist

Department of anesthesiology and intensive care for women

Ніна Іванівна Литвиненко, KE "Dnepropetrovsk specialized clinical center of mother and child named prof. M. F. Rudnev 26 Pushkin ave., Dnepropetrovsk, Ukraine, 49006

Anesthesiologist

Department of anesthesiology and intensive care for women

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Published

2015-11-27

Issue

Section

Medical