title: Acute effects of combined burn and smoke inhalation injury on carboxyhemoglobin formation, tissue oxygenation, and cardiac performance.
abstract: The objective of this study was to determine the relationship between carboxyhemoglobin (COHb) formation, global oxygen transport, and cardiac performance in the acute phase of combined burn and smoke inhalation injury. Following a third degree burn of 20% of the total body surface area, adult sheep were subjected to cotton smoke (4x12 breaths) according to an established protocol. Compared with baseline (BL), the burn injury led to an immediate and sustained COHb-independent depression in myocardial contractility. Despite a progressive increase in COHb formation, up to a maximum of 78+/-3% (P < 0.001 vs BL), smoke inhalation did not further impair these hemodynamic changes. This study demonstrated that in the early stage of combined burn and smoke inhalation injury, the depression in cardiac function is basically triggered by the burn injury, whereas COHb generation secondary to cotton smoke exposure primarily contributes to pulmonary shunting.
authors.affiliation: Investigational Intensive Care Unit, Department of Anesthesiology, University of Texas Medical Branch, and Shriners Burns Hospital for Children, Galveston, TX, USA. Martin.Westphal@gmx.net
authors.forename: Martin
authors.initials: M
authors.lastname: Westphal
authors.forename: Naoki
authors.initials: N
authors.lastname: Morita
authors.forename: Perenlei
authors.initials: P
authors.lastname: Enkhbaatar
authors.forename: Kazunori
authors.initials: K
authors.lastname: Murakami
authors.forename: Lillian
authors.initials: L
authors.lastname: Traber
authors.forename: Daniel Lee
authors.initials: DL
authors.lastname: Traber
mesh_terms: D000818:Animals; D002056:Burns / Q000378:metabolism*; D002263:Carboxyhemoglobin / Q000096:biosynthesis*; D010100:Oxygen / Q000378:metabolism*; D012756:Sheep; D015208:Smoke Inhalation Injury / Q000378:metabolism*
chemical_list: D002263:Carboxyhemoglobin; D010100:Oxygen