The effect of severe trauma on muscle energy metabolism in man.

Muscle energy metabolism after severe trauma was studied in four nutritionally isocaloric groups of patients, receiving different amounts of glucose, fat and nitrogen. Muscle biopsy was performed 2, 4, 8 and 30 days after trauma. The pattern of energy metabolites was similar in all groups. Adenosine triphosphate was decreased on day 8, with further fall on day 30. Phosphoryl-creatine was reduced from day 2 onwards. Concomitant creatine increase gave a constant total creatine pool up to day 8 post-trauma. Lactate was increased and glycogen moderately decreased. The single exception to the pattern was greater increment of lactate and maintenance of glycogen levels in the specimens from groups with high glucose intake. The reduction in high-energy phosphates could have resulted from impaired substrate utilization or rapid degradation of tissue energy stores. The glucose and the lipid system were equally effective in supporting the cellular energy status after severe trauma.