Arginine in burn injury improves cardiac performance and prevents bacterial translocation

Horton, Jureta W., Jean White, David Maass, and BillySanders. Arginine in burn injury improves cardiac performance andprevents bacterial translocation. J. Appl.Physiol. 84(2): 695-702, 1998.This studyexamined the effects of arginine supplement of fluid resuscitation fromburn injury on cardiac contractile performance and bacterialtranslocation after a third-degree burn comprising 43% of the totalbody surface area in adult rats. Before burn injury, rats wereinstrumented to measure blood pressure; after burn (or sham injury),paired groups of sham-burned and burned rats were given vehicle(saline), L-arginine,D-arginine, orN-methyl-L-arginine(300 mg/kg in 0.3 ml of saline 30 min, 6 h, and 23 h postburn) plusfluid resuscitation; sham-burned rats received drug only.Twenty-four hours after burn trauma, hemodynamics were measured; theanimals were then killed and randomly assigned to Langendorff heartstudies or to studies examining translocation of gut bacteria. Burnrats treated with vehicle, D-arginine, orN-methyl-L-argininehad well-defined cardiocirculatory responses that included hypotension,tachycardia, respiratory compensation for metabolic acidosis,hypocalcemia, cardiac contractile depression, and significant bacterialtranslocation. Compared with values measured in vehicle-treated burnrats, L-arginine given afterburn improved blood pressure, prevented tachycardia, reduced serumlactate levels, improved cardiac performance, and significantly reducedbacterial translocation, confirming that L-arginine administration afterburn injury provided significant cardiac and gastrointestinalprotection. Circulating neutrophil counts fell after burn trauma andserum glucagon levels rose, but these changes were not altered bypharmacological intervention. Our finding of significantly highercoronary perfusate guanosine 3,5-cyclic monophosphateconcentration inL-arginine-treated burn ratssuggests that the beneficial effects ofL-arginine were mediated bynitric oxide production.