Burns
Conditions
Keywords
Severe burns, Hyperinsulinemia, Insulin, Muscle protein kinetics, Immune function, Exercise
Brief summary
The purpose of this study is to examine the effects of insulin on helping burn patients recover faster from their burns.
Detailed description
Severe injuries produce profound hypermetabolic stress responses which cause severe loss of lean body mass and muscle wasting, immunologic compromise, slowed wound healing, and related bone loss, all which contribute to increased morbidity, mortality, and prolonged recovery from injury. The results of hypermetabolism persist for weeks to months depending on the severity of the insult. Massive burns can cause severe catabolism and are an excellent model to study the general effects of injury on protein metabolism. Severe burns are characterized by dramatic increases in energy utilization and alterations in the metabolism of carbohydrates, fat, and protein. Insulin treatment improves net protein synthesis in the severely burned, principally through improved muscle protein synthesis. Although controversy exist as to whether insulin is effective as an anabolic hormone through increasing protein synthesis or decreasing protein breakdown, we believe that consideration of the methods and experimental protocols used in the various studies bear consideration when evaluating this topic.
Interventions
DRUGInsulin
IV insulin
DRUGStable Isotopes
IV administration of stable isotopes
DRUGIndocyanine Green
IV administration of ICG
Sponsors
The University of Texas Medical Branch, Galveston
United States Army Institute of Surgical Research
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 72 Years
Healthy volunteers
No
Inclusion criteria
* Burn equal to or greater than 20% total body surface area (TBSA) * Between the ages of 18-72 years * Burns occurred within 14 days of coming to burn center
Exclusion criteria
* Heart attack within 3 months * Have or have had cancer * Seizure disorder * Pregnancy * Pre-existing arterial insufficiency * Diabetes or known history of hypoglycemia * Allergy to iodine or shellfish
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To determine the effect of euglycemic hyperinsulinemia throughout the hospital course on net muscle protein synthesis, and to relate continued muscle anabolism to improved lean body mass and improved functional recovery in severely burned patients | 45 days |
| To assess the relationship of insulin physiologic and molecular effects on skeletal muscle in severely burned patients | 45 days |
Countries
United States
Outcome results
None listed