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Transcapillary colloid osmotic pressures in injured and non-injured skin of seriously burned patients |
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| Authors: | J Pitk?nen T Lund L Aanderud R K Reed |
| Affiliation: | 1. Burn Center (Departments of Plastic Surgery and Anesthesiology), University of Bergen, Norway;1. Department of Physiology, University of Bergen, Norway;1. Center for Emergency Medicine, Community Health Centre Maribor, Proletarskih brigad 22, 2000 Maribor, Slovenia;2. Department of Physiology, Faculty of Medicine, University of Maribor, Taborska 8, 2000 Maribor, Slovenia;3. Department of Emergency Medicine, Faculty of Health Sciences, University of Maribor, Žitna 15, 2000 Maribor, Slovenia;4. Department of Emergency Medicine, Faculty of Medicine, University of Maribor, Taborska 8, 2000 Maribor, Slovenia;5. Department of Anaesthesiology, Intensive Care and Pain Management, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia;6. Department of Anaesthesiology and Reanimation, Faculty of Medicine, University of Maribor, Taborska 8, 2000 Maribor, Slovenia;1. Dental Materials, College of Dentistry, University of Oklahoma Health Sciences Center, 1201 N. Stonewall Avenue, Oklahoma City, OK 73117, United States;2. Microbiology and Immunology, College of Medicine, University of Oklahoma Health Sciences Center, 940 Stanton L. Young Blvd., BMSB 1053, Oklahoma City, OK 73104, United States;3. Restorative Dentistry, Oregon Health & Science University, MRB424, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States |
| Abstract: | Thermal skin injury is accompanied by rapid and excessive oedema formation implicating a dramatic increase in the transcapillary fluid transport. In order to clarify the pressure changes occurring across the microvasculature after a thermal skin injury we have measured colloid osmotic pressures (COP) in interstitial fluid (COPi) of injured and non-injured skin as well as in plasma (COPp) from patients suffering major cutaneous burns. Interstitial fluid was collected with a wick-technique and analysed for COP. Measurements were performed as early as 6 h and continued until 56 h after injury. A severe hypoproteinaemia occurred in all patients with a marked reduction in COPp down to about 10 mmHg. Up to 12h post-burn we found a higher COPi in injured skin than in plasma. The first measurement of COPp averaged 9.8 mmHg as compared to an average COPi of 11.1 and 9.3 mmHg in injured and non-injured skin respectively. Measurements performed later than 12h showed a return of the transcapillary COP gradient towards the normal direction (COPp greater than COPi). The gradient was considerably less than in a normal situation. Based on the present observations of transcapillary COP it is suggested that colloids should be withheld until the transcapillary COP gradient returns to the normal direction. |
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