Fluid resuscitation following a burn injury: Implications of a mathematical model of microvascular exchange

被引:13
作者
Bert, J
Gyenge, C
Bowen, B
Reed, R
Lund, T
机构
[1] Department of Chemical Engineering, University of British Columbia, Vancouver, BC
[2] Department of Physiology, University of Bergen, N 5009 Bergen
[3] Dept. Anesthesia and Intensive Care, Haukelund University Hospital
[4] Department of Chemical Engineering, 2216 Main Mall, University of British Columbia, Vancouver
关键词
burns; human; mathematical model; microvascular exchange; fluid resuscitation;
D O I
10.1016/S0305-4179(96)00115-5
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
A validated mathematical model for microvascular exchange in thermally injured humans has been used to predict the consequences of different forms of resuscitation and potential modes of action of pharmaceuticals on the distribution and transport of fluid and macromolecules in the body. Specifically, for 10 and/or 50 per cent burn surface area injuries, predictions are presented for no resuscitation, resuscitation with the Parkland formula (a high fluid and low protein formulation) and resuscitation with the Evans formula (a low fluid and high protein formulation). As expected, Parkland formula resuscitation leads to interstitial accumulation of excess fluid, while use of the Evans formula leads to interstitial accumulation of excessive amounts of proteins. The hypothetical effects of pharmaceuticals on the transport barrier properties of the microvascular barrier and on the highly negative tissue pressure generated postburn in the injured tissue were als investigated. Simulations predict a relatively greater amelioration of the acute postburn edema through modulation of the postburn tissue pressure effects. (C) 1997 Elsevier Science Ltd for ISBI.
引用
收藏
页码:93 / 105
页数:13
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