The 1990 Everett Idris Evans memorial lecture: the inhalation injury. 1990

P R Zellner
Department of Plastic Surgery, Berufsgenossenschaftliche Unfallklinik Ludwigshafen, Federal Republic of Germany.

The most important question that had to be answered from our animal data was whether a significant difference existed between the two groups. It could be observed that the resuscitation with Ringer's lactate did not lead to any increased lymph flow or total transcapillary protein flow in spite of the drop in protein and oncotic pressure in plasma. With Ringer's lactate there was a lower lymph to plasma protein ratio, which might be significant. No negative difference could be observed either in the pulmonary capillary wedge pressure or pulmonary vessel resistance. All animals survived throughout the experiment, and in all experiments no advantages regarding the vital parameters could be ascertained with the administration of albumin; however, several factors must be borne in mind. The inhalation injury was from a heat source alone and no toxic substances were involved. Only inhalation trauma was induced in the absence of a surface burn wound. The duration of the observation was for only 36 hours. Thus some caution must be observed in applying these findings to a clinical situation. In our evaluation of the clinical results, we have seen that no differences could be established in regard to pulmonary capillary wedge pressure and extravascular lung water between the Ringer's lactate and the albumin group. In spite of a 50% drop in oncotic pressure, however, this is only valid for the first 24 to 36 hours, after which one could assume that a further protein drop coupled with a still raised hydrostatic filtration coefficient would lead to interstitial edema.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D007552 Isotonic Solutions Solutions having the same osmotic pressure as blood serum, or another solution with which they are compared. (From Grant & Hackh's Chemical Dictionary, 5th ed & Dorland, 28th ed) Solutions, Isotonic
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D010539 Permeability Property of membranes and other structures to permit passage of light, heat, gases, liquids, metabolites, and mineral ions. Permeabilities
D002059 Burns, Inhalation Burns of the respiratory tract caused by heat or inhaled chemicals. Inhalation Burns,Burn, Inhalation,Inhalation Burn
D005440 Fluid Therapy Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to WATER-ELECTROLYTE BALANCE. Fluids may be administered intravenously, orally, by intermittent gavage, or by HYPODERMOCLYSIS. Oral Rehydration Therapy,Rehydration,Rehydration, Oral,Oral Rehydration,Rehydration Therapy, Oral,Therapy, Fluid,Therapy, Oral Rehydration,Fluid Therapies,Oral Rehydration Therapies,Oral Rehydrations,Rehydration Therapies, Oral,Rehydrations,Rehydrations, Oral,Therapies, Fluid,Therapies, Oral Rehydration
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077325 Ringer's Lactate A crystalloid solution that contains SODIUM CHLORIDE; SODIUM LACTATE; POTASSIUM CHLORIDE; and CALCIUM CHLORIDE. It is used for FLUID THERAPY. Hartmann's Solution,Hartmanns Solution,Lactated Ringer's Solution,Lactated Ringers Solution,Ringer's, Lactated,Ringers Lactate,Lactate, Ringer's,Lactate, Ringers,Lactated Ringer Solution,Lactated Ringer's,Ringer's Solution, Lactated,Ringers Solution, Lactated
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D012756 Sheep Any of the ruminant mammals with curved horns in the genus Ovis, family Bovidae. They possess lachrymal grooves and interdigital glands, which are absent in GOATS. Ovis,Sheep, Dall,Dall Sheep,Ovis dalli

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