The Metabolic and Ventilatory Response to the Infusion of Stress Hormones

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Abstract
Sepsis and trauma result in increases in epinephrine, glucagon, and cortisol secretion as well as alterations in respiratory pattern that is characterized by increased minute ventilation, decreased tidal volume, and increased frequency. Six male subjects were infused for 5.5 hours with cortisol, epinephrine, and glucagon in amounts designed to simulate plasma levels seen in patients following trauma. During the initial 20 minutes of the hormone infusion, minute ventilation (.ovrhdot.VE) oxygen consumption (.ovrhdot.VOF2), and carbon dioxide production (.ovrhdot.VCO2) increased above preinfusion values. .ovrhdot.VCO2 increased more than .ovrhdot.VO2 resulting in an increase in respiratory quotient (RQ) rom 0.93 to 1.14. The increase in .ovrhdot.VFE was due to increased tidal volume and not frequency (f). After 4.5 hours, the .ovrhdot.VE, .ovrhdot.VO2, and .ovrhdot.VCO2 were still above preinfusion levels but the RQ had decreased to 0.98 because of a decrease in .ovrhdot.VCO2. Frequency had increased from 19 .+-. 4.8 breaths/min preinfusion to 22 .+-. 4.7 after 4.5 hours. After 4.5 hours, VT was still above preinfusion levels while pH and PaCO2 had decreased below them. The latter was associated with an increase in serum lactate. At no time was a decrease in tidal volume observed. Therefore, the infusion of these hormones does not simulate all the alterations observed during trauma and sepsis.