Nitrogen sparing and the catabolic hormones in patients nursed at an elevated ambient temperature following major surgery

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Abstract
Fasted patients managed at an elevated ambient temperature following major surgery have reduced nitrogen excretion and body protein catabolism. To investigate the mechanism behind this three 24 h urine collections were made in 16 patients nursed for 48 h following aortobifemoral surgery on a Clinitrron fluidized bed at 32°C and analysed for total urinary nitrogen, cortisol and catecholamine excretion. Results were compared with a similar group of patients nursed throughtout on a standard ITU bed at 22°C. Patients mangaged at the elevated ambient temperature showed a significant reduction in the cumulative total urinary nitrogen (20.73 g±6.42 v 28.95 g±6.44; mean±S.D.;ppr=+0.414;p=0.02;n=32) and noradrenalin (r=+0.369;p=0.05;n=32). These results confirm that the beneficial effect of an elevated ambient temperature on postoperative protein metabolism is brought about through a reduction in metabolic stress.