Environmental Temperature and Metabolic Response to Injury Protein, Mineral and Energy Metabolism

  • D. P. Cuthbertson
  • G. S. Fell
  • A. G. Rahimi
  • W. J. Tilstone
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 33)


The post-shock generalized metabolic response to moderate to severe physical injury first described by Cuthbertson (1930, 1932, 1936, 1942) is a complex series of reactions with increased net protein catabolism and parallel increases in oxygen consumption as the main events. The changes in protein catabolism are exhibited as increased urinary losses of nitrogen (mainly as urea), sulphur (mainly as sulphate), phosphorus as phosphate, potassium, zinc and creatine but not creatinine (Cuthbertson, McGirr and Robertson, 1939; Cuthbertson, Fell, Smith and Tilstone 1972). This was termed the ‘flow’ phase of metabolism following the ‘ebb’ phase of diminished metabolism and heat production of the shock period (Cuthbertson, 1942). Muscle was implicated as the major source of nitrogen loss (Cuthbertson, 1942; Munro, 1964). The fractional catabolic rate of plasma albumin is increased and there is also a characteristic change in levels of plasma proteins with a fall in albumin and rises in the acute phase reactants (see Owen, 1967; Cuthbertson and Tilstone, 1969). The slight degree of fever which is generally present for a few days and which is apparently non microbial in origin was termed ‘traumatic fever’ and the whole reaction was considered as the generalized component of the inflammatory response.


Heat Production Metabolic Response Protein Catabolism Coulometric Titration Food Nitrogen 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Barr, P.O., Burke, G. Liljedahl, S.O. and Plantin, L.O. (1968) Lancet 1, 164.CrossRefGoogle Scholar
  2. Cairnie, A.B., Campbell, R.M., Cuthbertson, D.P. and Paliar, J.D. (1967) Br. J. exp. Patbol. 38, 504Google Scholar
  3. Caldwell, F.T. (1962) Ann. Surg. 155, 119CrossRefGoogle Scholar
  4. Caldwell, F.T. (1970). In Energy Metabolism in Trauma. Ciba Foundation Symposium, p.23 ed. Porter, R. and Enight, J.C. London, Churchill.Google Scholar
  5. Campbell, R.M. and Cuthbertson, D.P. (1967). Q.J1 exp.Physiol. 52, 114.Google Scholar
  6. Cuthbertson, D.P. (1930). Biochem. J. 24, 1244.Google Scholar
  7. Cuthbertson, D.P. (1932). Q.J1 Med. 25, 233.Google Scholar
  8. Cuthbertson, D.P. (1936). Br. J. Surg., 23, 505.CrossRefGoogle Scholar
  9. Cuthbertson, D.P. (1942). Lancet, 1, 433.CrossRefGoogle Scholar
  10. Cuthbertson, D.P., Fell, G.S., Smith, C.M. and Tilstone, V.J. (1972) Nutrition and Metabolism, in press.Google Scholar
  11. Cuthbertson, D.P., McGirr, J.L. and Robertson, J.S.M. (l939).Q.Jl exp. Physiol., 29, 18.Google Scholar
  12. Cuthbertson, D.P., Smith, C.M. and Tilstone, V.J. (1968). Br. J. Surg. 55, 513.CrossRefGoogle Scholar
  13. Cuthbertson, D.P. and Tilstone, V.J. (1969). Adv. clin.Chem., 12, 1.CrossRefGoogle Scholar
  14. Cuthbertson, D.P. Tilstone, V.J. and Green, J.A. (1969). Lancet, 1, 987.CrossRefGoogle Scholar
  15. Davies, J.V.L. and Liljedahl, S.O. (l970). In Energy Metabolism in Trauma. Ciba Foundation Symposium, p.59. ed Porter, R. and Knight, J. London, Churchill.Google Scholar
  16. Erici, I. (1954). Svensk, kir. Fören. Förh. 29th May. p.34. Also Abstr. in Nord.Med. (1955), 53, 128.Google Scholar
  17. Erici, I. (1957). Acta Chir. Scand. 112. 345Google Scholar
  18. Fleck, A. (1970). Proc.Nutr.Soc. 29, 81.CrossRefGoogle Scholar
  19. Henzel, J.H., de Veese, M.S. and Lichte, E.L. (1970). Arch.Surg. 100. 349.CrossRefGoogle Scholar
  20. Ingle, D.J., Vard, E.O. and Kuizenga, M.H. (1947).Am.J.Physiol. 149. 510.Google Scholar
  21. Kinney, J.M., (1967). Br. J. Surg. Lister Cent. No.435.Google Scholar
  22. Kinney, I.M., Long, C.L. and Duke J.H. (l970). In Energy Metabolism in Trauma. Ciba Foundation Symposium, p.105, ed. Porter, R. and Knight, J., London, Churchill.Google Scholar
  23. Long, C.L., Spencer, J.L., Kinney, J.M. and Geiger, J.W. (1971a). J. Appl. Physiol, 31, 102.Google Scholar
  24. Long, C.L., Spencer, J.L., Kinney, J.M. and Geiger, J.W. (1971b). J. Appl. Physiol. 31, 110.Google Scholar
  25. McCance, R.A. and Widdowson, E.M. (1960). The Composition of Foods. M.R.C. Special Report Series, No.297. London, H.M.S.O.Google Scholar
  26. Miksche, L.W. and Caldwell, F.T. (1967). Ann Surg. 54, 455.Google Scholar
  27. Munro, H.N. (1964). In Mammalian Protein Metabolism, Vol.2, p.381; ed. Munro, H.N. New York and London, Academic Press.Google Scholar
  28. Munro, H.N. and Chalmers, M.I. (1945). Br.J.exp.Pathol. 26, 396Google Scholar
  29. Munro, H.N. and Cuthbertson, D.P. (1943). Biochem. J. 37, xiiGoogle Scholar
  30. Owen, J.A. (1967). Advan.Clin.Chero. 9, 1.CrossRefGoogle Scholar
  31. Stoner, H.B. (l970). In Energy Metabolism in Trauma. Ciba Foundation Symposium, p.1. ed. Porter, R. and Knight, J.London, Churchill.Google Scholar
  32. Tilstone, W.J. and Fell, G.S. (197l). In: Automation in Analytical Chemistry, p.75. London Tech. Instrument Co. Ltd.Google Scholar
  33. Tilstone, W.J. and Roach, R.J. (1969). Q.J1. exp. Physiol. 54, 341.Google Scholar

Copyright information

© Plenum Press, New York 1973

Authors and Affiliations

  • D. P. Cuthbertson
    • 1
  • G. S. Fell
    • 1
  • A. G. Rahimi
    • 1
  • W. J. Tilstone
    • 1
  1. 1.University Department of Pathological BiochemistryRoyal InfirmaryGlasgow C.4UK

Personalised recommendations