Early Treatment of Shock and Injury
Annual rept. 27 Sep 2010-26 Sep 2013
MISSOURI UNIV-KANSAS CITY
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This study has rested on the basic hypothesis that agents given during and shortly after resuscitation can favorably influence the systemic inflammatory response to hemorrhagic shock and injury. This hypothesis has been shown to be true in the animal model. Of possible therapeutic agents possible, three were identified for potential human use. Glutamine was the first to be used in patients. Clinical studies have not supported the use of this agent. Arginine has been successful in the animal model, but has not been used in for this purpose in humans. Clinical studies in the literature are mixed regarding its safety in shock. Allopurinol has been shown in the past to be successful, in animal models, but recent experiments have failed to confirm benefit. Studies were also carried out using alanine-glutamine dipeptide, which has substantial advantages over glutamine. But clinical studies by others have failed to show benefit of this agent. It is used widely in Europe, but the US FDA has not approved it for use, and it is unlikely to become available for US use.
- Medicine and Medical Research
- Stress Physiology