Fluid distribution and pulmonary dysfunction following burn shock.
Respiratory function and body fluid changes were measured in 46 burned patients for up to 7 days postburn (DPB). The patients in this prospective study were divided into an HLS group [n = 17, burn size 61 +/- 0.5% BSA (mean +/- SEM), resuscitated with hypertonic lactated saline] and an iso-Na group (n = 29, burn size 60 +/- 4.5% BSA, resuscitated with lactated Ringer's solution). During DPB 3 to 5, the Respiratory Index (A-aDO2/PaO2), functional extracellular fluid volume (f-ECFV), an ratio of plasma volume to interstitial fluid volume (PV/ISFV) were increased in the iso-Na group compared with the HLS group. During the same period, the Respiratory Index and PV/ISFV correlated significantly; respiratory dysfunction was less in the HLS group. Nearly 50% of the iso-Na group required endotracheal intubation. Sodium loads were the same in both groups; the HLS group required less water. These results suggest that extracellular fluid distribution differs between the two treatments; HLS may be associated with ameliorated respiratory function not only because of less volume loading during resuscitation, but also because the PV/ISFV ratio is less than when lactated Ringer's is administered.
Shimazaki
S
S
Department of Traumatology and Critical Care Medicine, Kyorin University School of Medicine, Tokyo, Japan.
Yukioka
T
T
Matuda
H
H
D000328:Adult; D001810:Blood Volume; D002056:Burns / Q000503:physiopathology*; D005110:Extracellular Space; D006801:Humans; D007552:Isotonic Solutions / Q000008:administration & dosage; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange; D012119:Respiration; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage; D012769:Shock / Q000503:physiopathology* / Q000628:therapy; D013997:Time Factors
D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic