Early cardiorespiratory patterns in severely burned patients with concomitant inhalation injury.
Hemodynamic and oxygenation parameters were determined during the first 24 h in 13 burned patients with concomitant inhalation injury (burn surface area 40-60 percent). In all patients right ventricular function was severely compromised evidenced as a significant increase in end-diastolic volumes, decrease in ejection fractions, low stroke work indices and increased pulmonary vascular resistances. Inotropic support with dobutamine and careful titration of volume infusion according to end-diastolic volume indices improved the hemodynamics as demonstrated by significant increases in right ventricular ejection fractions in all patients without any changes in mean arterial pressures, urine output and oxygenation. Assessment of ventricular performance by a specially designed pulmonary artery catheter is helpful in the management of severely burned patients with concomitant inhalation injury.
Schultz
A M
AM
Department of Anesthesia and General Intensive Care (A), School of Medicine, University of Vienna, Austria.
Werba
A
A
Wolrab
C
C
D000328:Adult; D001784:Blood Gas Analysis; D002056:Burns / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D002059:Burns, Inhalation / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D006328:Cardiac Catheterization; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D004280:Dobutamine / Q000008:administration & dosage / Q000627:therapeutic use; D004333:Drug Administration Routes; D004359:Drug Therapy, Combination; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007552:Isotonic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D009569:Nitric Oxide / Q000008:administration & dosage / Q000627:therapeutic use; D012131:Respiratory Insufficiency / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D000077331:Ringer's Solution; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*
D002316:Cardiotonic Agents; D007552:Isotonic Solutions; D009569:Nitric Oxide; D004280:Dobutamine; D000077331:Ringer's Solution