Mediators of Post Burn Lung Water Changes,
CHILDREN'S HOSPITAL MEDICAL CENTER BOSTON MASS
Pagination or Media Count:
Measurable increases in lung water have been reported in both patients and animals in the resuscitation and early post resuscitation period after major body burns. These increases in extravascular lung water EVLW are modest at best and in general are not responsible for the early pulmonary dysfunction. This is primarily due to airways abnormalities either from a direct insult such as smoke inhalation, or due to hypoventilation as a result of 1 decreased chest wall compliance from tissue edema 2 pain or 3 the treatment of pain. A generalized increase in vascular permeability including the lung has been reported to occur after a major body burn leading to an early pulmonary edema. We have reported a modest increase in fluid flux from the vascular to the extravascular space in the lung after a body burn in the adult sheep using lymph flow Q sub L to reflect fluid flux and the lymph to plasma protein ratio to reflect changes in protein permeability. We have, however, not found any increase in protein permeability. Normal sieving in macromolecules is maintained. This lack of increased lung permeability after burns and other forms of soft tissue trauma has been corroborated by others. We and others have also described a transient mild pulmonary hypertension in the immediate post burn period.