The relationship between experimental fluid therapy and wound edema in scald wounds.

摘要

It is evident clinically that fluid loads administered acutely after thermal injury increase wound edema, but this relationship has not been well defined. Scalded rats were given intravenous water loads of up to 40% body weight. Concomitantly, sodium and albumin loads were also varied around clinically recommended norms for resuscitation (0-48 mEq sodium/kg, albumin in concentration of 1-10%). Attendant edema and sodium content were measured in the wound and in uninjured skeletal muscle. Wound edema was found to be linearly related to the net volume of the fluid administered, irrespective, within wide limits, of its sodium or albumin content. The positivity of the slope of the regression of wound edema on administered volume varied depending on extent of the injury. The changes in uninjured muscle were comparatively small. Wound sodium content always closely paralleled water content. Since all of the treatments studied had an equivalent propensity to enter the wound, other criteria must be used to judge their efficacy in the resuscitation of acutely burned patients.