Comparison of postburn capillary permeability in soft tissue and lung

Robert H. Demling, Michael Smith, Balazs Bodai, Bruce Harms, Robert Gunther, George Kramer

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Impaired capillary integrity after severe thermal injury results in edema formation in both burned and non-burned soft tissue and also in the lung. Our purpose was to quantitate the permeability change in these vascular beds during the postburn (PB) period in order to define the pathophysiology and determine optimum use of colloid solutions. We prepared chronic lung lymph and bilateral flank soft tissue (prefemoral) lymph fistulae in 14 sheep. A 30% TBS full-thickness burn was produced on one side. Lymph flow (Q1). lymph protein flux and vascular pressures were monitored for 72 hours. Changes in capillary permeability were quantitated by determining the lymph-to-plasma (L/P) ratios for albumin and globulin. Capillary protein sieving was considered normal if L/P ratio decreased in response to an increase in Q1,. A two-fold increase in lung Q1was seen early PB, returning to baseline by 24 hours. The L/P ratio for albumin and globulin decreased indicating no protein permeability change. A two- to three-fold increase in Q1, was seen in the first 24 hours in nonburned (NB) soft tissue. Impaired albumin sieving was seen only in the first 12 hours. Globulin sieving was maintained. The correlation between changes in lung and MB Q1, in each animal was 0.8, suggesting a common etiology. A five- to ten-fold increase in Q1, was seen in burn tissue which persisted for the course of the study. Impaired sieving was seen for both albumin and globulin, with an increase in the L/ P ratios, during the first 48 hours. Our data indicate that albumin infusion would be effective for maintaining oncotic pressure across the lung immediately and NB tissue in the early PB period. Much larger molecules would be required for burn tissue.

Original languageEnglish (US)
Pages (from-to)86-92
Number of pages7
JournalJournal of Burn Care and Rehabilitation
Volume2
Issue number2
DOIs
StatePublished - Jan 1 1981
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Nursing(all)
  • Emergency Medicine
  • Rehabilitation
  • Health Professions(all)

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