Energy Exchanges and Injury

Abstract

The practical application of calorimetry to the study of energy expenditure after injury did not begin until 1930, with the work of Cuthbertson in Glasgow, who used relatively crude indirect calorimetry techniques to study patients with bone fractures. During the late recovery phase, he found increases in oxygen consumption of 15-q% above resting values, associated with a rise in rectal temperature These increases in metabolic expenditure were linked with evidence of increased protein breakdown (Cuthbertson, 1930, 193 I), thought to originate in muscle The injured rat displayed similar changes (Cuthbertson, 1939). Over the next two decades interest in the energetic consequences of injury waned, largely as a result of the poor accuracy and cumbersome nature of the calorimeters then available. Using radioisotope tracers and other advances, research into the metabolic response to injury centered upon biochemical, hormonal and cellular changes (Richards, 1977). Further indirect calorimetry studies were made (Cope, Nardi, Quijano, Rovit, Stanbury & Wright, 1953) in the early 1950s but they could not identify the cause of the hypermetabolism following injury.