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Pulmonary edema in an isolated lobe after inhalation injury
Authors:Z R Guo
Institution:PLA 304th Hospital, Beijing.
Abstract:In order to know the regularity of forming edema after thermal injury, we performed experiments of pulmonary edema in isolated lobes with steam and obtained direct continuous measurements of transudation as it occurs. Transvascular flux (Qf) and gain weight (Gw) of the lobe increased immediately and the peak value of exudation occurred within half an hour after inhalation injury. Studies in protein content, colloid osmotic pressure of bronchus exudate and water content of lung, reconfirmed increase in pulmonary capillary permeability. Marked hemoconcentration was revealed. Plasma leaked 145 ml (32.5%), plasma protein leaked 2.9 g (15%) during the experiment. According to pressure of artery (Pa), vein (Pv), arterial occlusion (Pao), venous occlusion (Pvo), double occlusion (Pdo) and blood flow through the lobe (QT), the total vascular (Rt) arterial (Ra), middle compartment (Rmid), and venous (Rv) resistances were calculated. All the resistances indicated an increase and QT showed a decrease after inhalation injury. The experimental results suggested that tissue ischemia is significant after thermal injury and resuscitation should be started as early as possible and should include whole blood or plasma in resuscitation regimes during burn shock phase.
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