ABSTRACT
1. The salt complex of L-(+)-ornithine and alpha-ketoglutarate (2-oxoglutarate) has recently been proposed for the treatment of patients in the catabolic state. As yet, it is unclear which of the two substrates (ornithine or alpha-ketoglutarate) is responsible for the anticatabolic effect. We infused alpha-ketoglutarate into anaesthetized post-operative dogs in order to investigate whether infusion of alpha-ketoglutarate affects the flux of glutamine and glutamate between skeletal muscle and the splanchnic bed. We used three infusion rates: 3, 10 and 20 mumol min-1 kg-1. A steady state of alpha-ketoglutarate concentration in arterial whole-blood was attained only when the infusion rate was 3 mumol min-1 kg-1. 2. Arterial whole-blood concentrations of alpha-ketoglutarate were 8.8 +/- 1.2 mumol/l in the basal period and rose to 208 +/- 41, 344 +/- 61 and 1418 +/- 315 mumol/l after 60 min infusions of alpha-ketoglutarate at 3, 10 and 20 mumol min-1 kg-1, respectively. 3. alpha-Ketoglutarate uptake was measured in skeletal muscle, liver, gut and kidneys in the basal period and during the infusion of alpha-ketoglutarate. The net uptake of infused alpha-ketoglutarate was highest in the skeletal muscle, followed by kidneys, liver and gut. 4. The alpha-ketoglutarate load increased the muscular tissue content of alpha-ketoglutarate from 49.5 +/- 5 to 142 +/- 15 nmol/g of dry substance (P less than 0.001), but did not alter the muscular glutamate or glutamine contents.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Glutamates/metabolism , Glutamine/metabolism , Ketoglutaric Acids/administration & dosage , Kidney/drug effects , Proteins/metabolism , Animals , Dogs , Infusions, Intravenous , Intestinal Mucosa/metabolism , Intestines/drug effects , Ketoglutaric Acids/pharmacology , Liver/drug effects , Liver/metabolism , Male , Muscles/drug effects , Muscles/metabolismSubject(s)
Apolipoproteins/metabolism , Lipid Metabolism , Lipoproteins/metabolism , Emulsions , Humans , Particle SizeSubject(s)
Postpartum Hemorrhage/epidemiology , Puerperal Disorders/diagnosis , Female , Humans , Physical Examination , Postpartum Hemorrhage/prevention & control , Pregnancy , Puerperal Disorders/prevention & control , Puerperal Infection/diagnosis , Puerperal Infection/epidemiology , Puerperal Infection/prevention & controlABSTRACT
The treatment of gas gangrene has been revolutionized by oxygen drenching of tissues infected with Clostridia. This was used in a massive infection of the abdominal wall following a traumatic abortion attempt. The clostridial infection was controlled, but the patient almost succumbed to a secondary infection of gram-negative organisms. This responded to drainage, antibiotics and general supportive measures. In the course of treatment, the value of a team approach to complicated special problems was documented.
