Violation of protein metabolism

Extensive deep burns, causing destruction of a large number of tissue and serum proteins and increased selection of nitrogenous substances from the body, are already in the first hours after the injury to significant changes in protein metabolism. The appearance soon after burn negative protein balance kept extremely long time, found both Soviet and foreign scientists. It was found that the degree of disturbance of the nitrogen balance and disintegration of proteins in the organism is directly dependent on the area and the depth of the burn.
N. N. Dei priori, V. D. Bratus, Taylor (Taylor D.), and others indicate that the disturbed balance of nitrogenous with severe burns are not able to recover during the whole period of illness neither rich in protein food or transfusion of blood and plasma. This allows to conclude that alimentary factor did not play a major role in the emergence of negative nitrogen balance.
Research has established that burns not accompanied by oliguria, selection of nitrogen with urine in the first hours sharply increases. Along with this releases massive amounts of protein nitrogen with wound exudate, the amount of which with extensive burns may be 30% of the total allocated nitrogen. Therefore, many authors believe that the main reason of violation of the nitrogen balance in the burnt is quick disintegration of tissue proteins and excessive release of nitrogen with urine and wound exudate (Fox, Baer and other).
Allgower (Allgower M) found that the body is burnt in the first days after injury loses daily capacity up to 250 g of protein, which is 40 grams of nitrogen.
According to N. N. Possible expansion, together with edema fluid body loses in the first days after extensive burn per day up to 150 g of protein (24 grams of nitrogen). Nitrogen wound exudate is mostly protein nitrogen and is formed by the disintegration of proteins of burnt tissues, and by vyhozhdeniya of blood vessels of a large number of proteins in the serum of blood. However, protein substances, falling excess amount in the intercellular space, as in the affected area and in the remote from the site of the burn areas only partly lost with wound exudate. The remainder when restoring resorption and decrease of tissue edema into the lymphatic vessels and is not irretrievably lost to the body.
Along with the collapse of tissue and serum proteins is the destruction and proteins of various enzyme systems, in particular, desaminase and decarboxylase, resulting in liver violated two key exchange process is the deamination pereaminirovanie and amino acids.
Content changes in blood and non-protein nitrogen. So, there are indications that the content of non-protein nitrogen in the blood of the burnt significantly increased in connection with the perversion of protein metabolism, as evidenced by the increase in the blood of the number of aminatta, urea, ammonia and especially of creatine. This is seen as an indicator of toxemia.
D. L. Leinburg, Radler (Rudler G.), Duval (Diival D.) and others drew attention to the increase in blood polypeptide nitrogen, which is an intermediate product of protein metabolism and believe that it is, above all, characterized protein disintegration in the body. It is known that accumulate in the blood polypeptides, as well as other products intermediate metabolism of protein, have a toxic effect on the organism of the patient.
D. L. Lyberg noted giperpoliarizatia and in the late period of the disease for 15-20 days. after burn, in good General condition and complete healing of wounds. The author believes that the discovered phenomenon is associated with impaired liver function.
Significant and characteristic changes in extensive burns observed in the protein composition of the blood serum. It is known that blood proteins, their General content, and especially the content of albumin and globulin fractions to a certain extent reflects the condition of the patient, and in advanced cases of the disease and prognosis. With extensive burns, normally decreases the amount of albumin and increases the amount of globulin, which partially can be explained, first, increased permeability of capillaries and, consequently, vihodnie in tissue aluminoase liver function. All this leads to the increase of the content of globulins and especially coarse gamma-globulin. It is established that if intravenous injections of the protein liquids possible even in severely ill to raise the number of total protein of blood to subnormal values, the ratio of protein fractions that can not be reached.
In our experiments on the study of burn injuries in animals showed that each phase currents of burn disease corresponds to an increase of some globulin fractions and decrease in others. So, in the stage of toxemia found a clear predominance of beta-globulin, and with the development of septicotoxemia content increases gamma-globulin (table. 6). Obviously, it may be associated with functional peculiarities of these factions globulin.