title: Oxygen consumption is increased in the postanesthesia period after burn excision.
abstract: We studied the intraoperative and postoperative effects of anesthesia and wound excision on oxygen delivery and oxygen consumption after burn injury. Twenty adult sheep were studied: six had halothane anesthesia alone and 14 had anesthesia and third-degree burns over 15% of the total body surface. Body temperatures were maintained within 1 degree C of baseline value during the operations. The burns on six sheep were totally excised and hide from donor sheep was grafted 3 hours after injury; in eight sheep, excision and grafting were done 5 days after injury. We found that 3 hours of anesthesia in controls decreased oxygen delivery (DO2) by 22% +/- 6% and oxygen consumption (VO2) by 30% +/- 7% from waking baseline values primarily because of a decrease in cardiac output as oxygen (O2) extraction from hemoglobin also decreased. However, no base deficit developed. DO2 and (VO2) transiently increased to 9% +/- 3% above baseline value on the sheeps' return to the waking state. Anesthesia and wound excision, which began 3 hours after the burns were formed, decreased DO2 and VO2 by 25% +/- 4% and 32% +/- 4%, respectively, despite baseline filling pressures. However, a base deficit of -3 +/- 1 mEq/L developed during the two-hour operations, which began with the administration of anesthesia alone. Oxygen consumption increased to 25% +/- 6% above the waking baseline value upon each subject's return to the waking state. In the sheep treated 5 days after burn injury, DO2 decreased by 35% +/- 6% and VO2 decreased by 42% +/- 6% below the value during the waking hypermetabolic state when the sheep were under anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)
authors: Longwood Area Trauma Center, Brigham Hospitals, Boston, Massachusetts.
authors: R H
authors: RH
authors: Demling
authors: C
authors: C
authors: Lalonde
mesh_terms: D000818:Animals; D002056:Burns / Q000503:physiopathology / Q000601:surgery*; D006221:Halothane / Q000494:pharmacology*; D006439:Hemodynamics; D007432:Intraoperative Period; D010101:Oxygen Consumption / Q000187:drug effects*; D011184:Postoperative Period; D012756:Sheep
chemical_list: D006221:Halothane