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Bacterial spread from the gut
337
Abstracts feeding
is better
than
i.v.
feeding
in burned
guinea-
pigs. Saito H.. Trocki 0.. Alexander J. W. et al. (1987) The effect of route of nutrient administration on the nutritional state, catabolic hormone secretion and gut mucosal integrity after burn injury. J. Parent. Enfr. Nurr. 11, (1). 1-7.
Bacterial spread from the gut The inthtence of protein malnutrition and endotoxaemia on bacterial translocation from the gut to the mesenteric lymph nodes, liver, spleen and bloodstream was determined in normal mice and mice with burns covering 25 per cent of the body surface. Although protein malnutrition was not followed by bacterial translocation from the gut in either the unburned or burned animals, such translocation did occur following a non-lethal dose of endotoxin given intraperitoneally. The translocation was confined to the mesenteric lymph nodes in the non-burned mice whereas the bacterial spread was generalized in the burned animals. The mortality rate of mice receiving only endotoxin or burns was less than 10 per cent, while the combination of endotoxin plus a burn increased the mortality rate to 100 per cent. Deitch E. A. and Berg R. D. (1987) Endotoxin but not malnutrition promotes bacterial translocation of the gut flora in burned mice. J. Trauma 27, (2), 16l166.
Metabolism
metabolism and the effect of various dietary intakes of fat on burn outcome. Without question burn patients show alterations in triglyceride, cholesterol, carnitine, fatty acid. lipoprotein and prostaglandin metabolism. While glucose appears to be more effective than fat as an cncrgy source in the nutritional support of severely hurncd patients. there is considerable benefit to the patient from conservative administration of fat, particularly linoleic acid. in view of its immunosuppressive and hyfrcrlipidacmic tendancies. Enrichment of the dietary fat input with eicosapentaenoic acid may likewise prove to be beneficial. Gottschlich M. M. and Alexander J. W. (1987) Fat kinetics and recommended dietary intake in burns. J. Parent. Entr. Nutr. 11, (I), 80-85.
lmmunosuppression tides
by
collagen-like
pep-
A low molecular weight collagen-like peptide complex found in patients with burns exceeding 40 per cent of the body surface was shown in tests in vitro to suppress neutrophil chemotaxis and the mixed lymphocyte response. Addition of lymphocytes pretreated with the peptide complex (Cfq) suppressed the mixed lymphocyte response, indicating activation of suppressor cells by the peptides. Rabbit anti Clq globulin reduced the suppressive activity of the collagen-like peptides derived from human bum sera. Thus Clq may be one of the factors inducing early immunosuppression following burns. Ninnemann J. L. and Ozkan A. N. (1987) The immunosuppressive activity of Clq degradation peptides. J. Trauma 27, (2) 119-122.
of fat in burns
A very comprchensivc review based on more than 90 rcfcrcnccs asscsscs the impact of burn injury on fat
Book Review Advances in Trauma, Vol. 1. Editor-in-Chief Kimball I.Maull. Associate editors Henry C. Cleveland, Gerald 0. Strauch and Charles C. Wolfetth. 234x 156 mm. Pp. xx+301. 1986. London: Year Book Medical Publishers (Distr. Wolfe Medical). Hardback, f4B.00. Fourteen advancing subjects in trauma are reviewed by authors from the USA, with a single contribution from Canada. Trauma severity scores are important in determining prognosis, and in the USA consideration of transfer to a major trauma centre; it is therefore an appropriate topic to comtpence with. Further general topics follow with discussion of nutritional care of the acutely in-
jured, antibiotics, radiology, exsanguination, and the adult respiratory distress syndrome. Specific subjects include intracranial haemorrhage, penetrating neck wounds, laryngeal trauma, highfrequency jet ventilation, thoracic injuries, pelvic trauma, external tixators and spinal cord injury research. All the chapters provide good reviews of the subjects and their advances together with remaining problems, and all chapters carr$ good bibliographiec Members of multidisciplinary teams wanting to keen UD with developments in other specialist apiroache’s tb aspects of polytrauma in fields outside their own will find much valuable information and food for thought here. J. PLEWES
Abstracts feeding
is better
than
i.v.
feeding
in burned
guinea-
pigs. Saito H.. Trocki 0.. Alexander J. W. et al. (1987) The effect of route of nutrient administration on the nutritional state, catabolic hormone secretion and gut mucosal integrity after burn injury. J. Parent. Enfr. Nurr. 11, (1). 1-7.
Bacterial spread from the gut The inthtence of protein malnutrition and endotoxaemia on bacterial translocation from the gut to the mesenteric lymph nodes, liver, spleen and bloodstream was determined in normal mice and mice with burns covering 25 per cent of the body surface. Although protein malnutrition was not followed by bacterial translocation from the gut in either the unburned or burned animals, such translocation did occur following a non-lethal dose of endotoxin given intraperitoneally. The translocation was confined to the mesenteric lymph nodes in the non-burned mice whereas the bacterial spread was generalized in the burned animals. The mortality rate of mice receiving only endotoxin or burns was less than 10 per cent, while the combination of endotoxin plus a burn increased the mortality rate to 100 per cent. Deitch E. A. and Berg R. D. (1987) Endotoxin but not malnutrition promotes bacterial translocation of the gut flora in burned mice. J. Trauma 27, (2), 16l166.
Metabolism
metabolism and the effect of various dietary intakes of fat on burn outcome. Without question burn patients show alterations in triglyceride, cholesterol, carnitine, fatty acid. lipoprotein and prostaglandin metabolism. While glucose appears to be more effective than fat as an cncrgy source in the nutritional support of severely hurncd patients. there is considerable benefit to the patient from conservative administration of fat, particularly linoleic acid. in view of its immunosuppressive and hyfrcrlipidacmic tendancies. Enrichment of the dietary fat input with eicosapentaenoic acid may likewise prove to be beneficial. Gottschlich M. M. and Alexander J. W. (1987) Fat kinetics and recommended dietary intake in burns. J. Parent. Entr. Nutr. 11, (I), 80-85.
lmmunosuppression tides
by
collagen-like
pep-
A low molecular weight collagen-like peptide complex found in patients with burns exceeding 40 per cent of the body surface was shown in tests in vitro to suppress neutrophil chemotaxis and the mixed lymphocyte response. Addition of lymphocytes pretreated with the peptide complex (Cfq) suppressed the mixed lymphocyte response, indicating activation of suppressor cells by the peptides. Rabbit anti Clq globulin reduced the suppressive activity of the collagen-like peptides derived from human bum sera. Thus Clq may be one of the factors inducing early immunosuppression following burns. Ninnemann J. L. and Ozkan A. N. (1987) The immunosuppressive activity of Clq degradation peptides. J. Trauma 27, (2) 119-122.
of fat in burns
A very comprchensivc review based on more than 90 rcfcrcnccs asscsscs the impact of burn injury on fat
Book Review Advances in Trauma, Vol. 1. Editor-in-Chief Kimball I.Maull. Associate editors Henry C. Cleveland, Gerald 0. Strauch and Charles C. Wolfetth. 234x 156 mm. Pp. xx+301. 1986. London: Year Book Medical Publishers (Distr. Wolfe Medical). Hardback, f4B.00. Fourteen advancing subjects in trauma are reviewed by authors from the USA, with a single contribution from Canada. Trauma severity scores are important in determining prognosis, and in the USA consideration of transfer to a major trauma centre; it is therefore an appropriate topic to comtpence with. Further general topics follow with discussion of nutritional care of the acutely in-
jured, antibiotics, radiology, exsanguination, and the adult respiratory distress syndrome. Specific subjects include intracranial haemorrhage, penetrating neck wounds, laryngeal trauma, highfrequency jet ventilation, thoracic injuries, pelvic trauma, external tixators and spinal cord injury research. All the chapters provide good reviews of the subjects and their advances together with remaining problems, and all chapters carr$ good bibliographiec Members of multidisciplinary teams wanting to keen UD with developments in other specialist apiroache’s tb aspects of polytrauma in fields outside their own will find much valuable information and food for thought here. J. PLEWES