Figure 77-14 Gluconeogenic response to trauma in 10 septic and 16 nonseptic patients. The mean values for plasma glucose and alanine in patients with sepsis after trauma (ST) are compared with those of patients with nonseptic post-trauma courses (NST). Notice the early rise in the plasma glucose level associated with an increase in plasma alanine in ST patients with progressive increase as the septic course evolves. (Adapted from Vary TC, Siegel JH: Sepsis, abnormal metabolic control and multiple organ failure syndrome. In Siegel JH [ed]: Trauma: Emergency Surgery and Critical Care. New York, Churchill Livingstone, 1987, p 411.)