Metabolic alterations in burn patients: detection of adenosine triphosphate degradation products and lipid peroxides

Seven patients admitted to the University of Michigan Burn Center with greater than 20 per cent total body surface area burns were studied for evidence of oxygen radical production, as demonstrated by serum lipid peroxides, and adenosine triphosphate (ATP) degradation, based upon ATP degradation products in blood (serum purines) and urine (urine purines and urine uric acid). Lipid peroxides (conjugated dienes) were elevated beginning on day 1 postburn and remained elevated up to day 5, the duration of the study. ATP degradation products were elevated during the initial 24 h postburn but rapidly fell to normal levels. This study provides evidence of biochemical alterations in thermally injured patients similar to observations in animal models which demonstrate that ATP degradation and the production of oxygen radicals are part of the initial response to thermal trauma.