Hormonal dysregulations in severe burns.

Measurements of the concentrations of pituitary, thyroid and gonadal hormones have been made under both basal conditions and after adequate stimulation using a combined arginine TRH-LHRH stimulation test in 10 patients with deep burns covering between 30 and 70 per cent of the body surface during the first 20 days after injury. The most remarkable changes were found in the pituitary-gonadal system with testosterone concentrations significantly decreased at all times during the periods of study. Stimulation with LHRH resulted in a prompt response of FSH and LH during the first 10 days after burning whereas between 10 and 20 days after injury the basal concentrations for both hormones were significantly lower and showed a delayed response to stimulation. During the period of early fluid therapy large amounts of glucose without additional insulin were given, resulting in elevated blood glucose and high plasma insulin levels. It is concluded that normal pancreatic insulin production is sufficient to avoid excessive hyperglycaemia even during the period soon after burning. Compared with the findings in control patients the HGH levels in burned patients were not significantly different at any time during the periods of study.