By Oscar Bodansky (ed.), C.P. Stewart (ed.)
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Extra resources for Advances in Clinical Chemistry, Vol. 12
Allen (A3) has shown that immersion of the ligated limb in water at METABOLISM DURING THE POSTINJURY PERIOD 29 temperatures a few degrees above normal room temperature greatly enhances the effects of tourniquet shock. On the other hand, reductions of temperature greatly reduce the dangers of ligation. Stoner (S14) studied the interaction between environmental temperature, cold acclimatization, and ischemic shock in the rat. At an environmental temperature of 18"-2OoC, rats show a fall in liver and brain temperature during the period (4 hours) of ischemia.
Even after a month there may be a slight negative balance, but normally there is a slow merging into an anabolic phase (52). I n burns loss of tissue plays a large part in the initial nitrogen depletion and this is only slowly made good: nevertheless, there is a marked catabolic response (B19, C15, H11, T l ) . More nitrogen may be eliminated in the course of 10 days following severe bony injury than is present in the whole of the liver ((321). The discharge, however, involves the liver, and we have earlier in this paper drawn attention to the effect of anoxemia on the capacity of the liver to deal with urea formation.
8 g/lOO ml (about 20% of the normal plasma albumin level), but decreases of twice this amount have been found in individual patients with the depression maximal between 4 and 10 days and sometimes normal values may not be regained for several weeks. The fall is particularly marked after extensive burns. Davis e t al. ( D l ) have noted an METABOLISM DURING THE POSTINJURY PEBIOD 17 increase in the rate of plasma albumin turnover in burned and injured patients with a maximum period of breakdown (2-3 times normal) coinciding with the peak of urinary nitrogen excretion.