Studies on plasma insulin levels in the posttraumatic phase in rabbits

The rise of blood sugar as an additional parameter in traumatic shock

Besides the known cardiovascular effects of hemorrhagic shock, regular metabolic consequences can be demonstrated in the rabbit: 1. The rise in blood sugar in hemorrhagic shock increases with the amount of blood withdrawn per unit of time. 2. The characteristic rise in blood sugar lasts longer than the phase of the partial exsanguination. 3. In traumatic shock, the rise in blood sugar indicates the degree of severity of the injury earlier than the fall in blood pressure does. The rise in blood sugar is attributable to a reflex increase in glycogenolysis due to catecholamine secretion elicited via baroreceptors in hemorrhagic shock. For the pronounced rise in blood sugar in traumatic shock, an additional receptor is postulated. Supplementary investigation of the blood sugar may possibly enable the extent of the injury to be diagnosed earlier in traumatic shock, and the negative sequelae may be reduced by timely, adequate therapy.

The rise of blood sugar as parameter for the degree of severity of hemorrhagic shock in the rabbit

Besides the known cardiovascular effects of hemorrhagic shock, the following regular metabolic consequences can be demonstrated in rabbits: The rise in blood sugar in hemorrhagic shock increases with the amount of blood withdrawn per unit time. The rise in blood sugar is independent of the state of consciousness or Nembutal anesthesia. The characteristic rise in blood sugar lasts longer than the partial exsanguination phase. The rise in blood sugar is attributed to an increased glycogenolysis due to a reflex triggering of catecholamine secretion via the baroreceptors in hemorrhagic shock. More attention to metabolic consequences of hemorrhagic shock may possibly give rise to consequences for diagnosis and therapy of shock.

Chronic tissue insulin resistance following hemorrhagic shock

Metabolism of fat and muscle tissue was measured for 30 days following shock and reinfusion in rabbits. Tissue insulin resistance in the post-shock period was demonstrated by decreased oxidation of glucose and decreased incorporation of glucose into neutral lipid or glycogen during incubation with insulin. In addition, the insulin stimulated incorporation of amino acids into muscle protein was markedly reduced after shock. Conversely, the capacity of muscle to oxidize leucine was enhanced by shock, even in the presence of insulin. Tissue insulin resistance and increased leucine catabolism are likely to contribute to the general metabolic response to shock and trauma.