THE CONTRIBUTION OF EFFUSED BLOOD TO THE PROTEIN CATABOLIC RESPONSE TO FRACTURE

¹ Rowett Research Institute, Aberdeen and the Department of Pathological Biochemistry, University and Royal Infirmary, Glasgow

Although injuries such as fracture of a long bone may lead to the effusion of a considerable amount of blood in the area of trauma, organization of the haematoma can play but a minor role in the increased urinary excretion of nitrogen and other catabolites which constitute the normal response to moderate or severe injuries in the well nourished man or lower animal at normal environmental temperatures (20-22°C) for the following reasons:

(1) adrenalectomy but without supporting corticosteroid abolishes the catabolic response;

(2) protein deprivation before injury also abolishes it;

(3) an environmental temperature of 30°C reduces the normal response;

(4) additional non-protein sources of energy in the diet reduce the catabolic response;

(5) infused blood is apparently not rapidly catabolized.

If the organization of a haematoma in the fracture site was the main source of the extra nitrogen found in the urine, then conditions 1-4 should likewise have demonstrated the effect. The fact that they did not supports the view that the organization of the haematoma or the presence of infused whole blood play but a relatively small and/or slow part in the characteristic protein catabolic response to fracture.

Note:

The Senior Author wishes to express his sincere thanks to the Medical Research Council for a Research Grant during the tenure of which this paper was prepared.