The effect of resuscitation on inhalation injury

Eighteen chronically instrumented sheep with lung-lymph catheters were studied. Inhalation injury was produced in 12 animals under halothane anesthesia and then studied for 24 hours. Six of the animals received 70 ml/m²/hr body surface area for 5% dextrose in Ringer's lactated solution (normal maintenance fluid requirements for sheep), and six received 140 ml/m²/hr (twice normal maintenance fluid requirements for sheep). Six additional animals were anesthetized, insufflated with air instead of smoke, and received 70 ml/m²/hr of resuscitation fluid (sham group). Twelve hours after injury, the recorded variables from the animals that were smoked and had received a high fluid resuscitation were not different from the sham group whereas the group with low-volume fluid resuscitation had a much higher lung-lymph flow and lymph-to-plasma protein concentration ratio and a lower cardiac output. The lung microvascular permeability changes seen with smoke inhalation are made worse by inadequate fluid resuscitation.