ISSN:0273-8481    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0273-8481    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

This review was undertaken to elucidate the trends in copper, zinc, total serum protein, and ceruloplasmin levels in patients ith hermal trauma. Medical records of pediatric and adult patients were retrospectively reviewed. The findings showed a significant linear decline in mean plasma copper, ceruloplasmin, and total serum protein during the first three days postburn, followed in general by a gradual rise in levels; however, patients with burns larger than 60% TBSA maintained copper, zinc, and ceruloplasmin levels significantly below the lower limits of normal during the observation period.Significant decrements in opper, zinc, total serum protein, and ceruloplasmin levels have been demonstrated in these patients. Trace metal determinations should be obtained in patients with significant burns soon after admission and routinely throughout their ospital ourse. Specific trace metal supplementation should be administered when indicated.

ISSN:0273-8481    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Transient hypertriglycericlemia occurs in patients with severe thermal injury, and some patients have a low learance of exogenous triglyceride (TG) from plasma. This suggests an impaired lipolysis. In the current study, we measured the levels of apolipoproteins required for clearance of endogenous and/or exogenous TG. Twenty-five thermal injury patients (18 men and 7 women) having an average of 52% ± 6% (SE) total burn surface area were followed for a period of nine weeks. The levels of plasma lipids and apolipoproteins C-II, C-III, E, and A-I were measured after a 12-hour “fast,” ie, prior to the parenteral administration of fat emulsion. The levels of plasma cholesterol and apolipoproteins C-II, C-III, and A-I were low. Plasma TG levels, however, were not abnormally elevated, while apo E levels were within normal range. The results indicate that therm-ally injured patients have reduced levels of apoproteins necessary for TG metabolism. This condition may predispose to intolerance of exogenous TG.

ISSN:0273-8481    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Recent studies suggest that lung lesions occurring in inhalation injury result from actions of oxygenfree radicals released from polymorphonuclear leukocytes marginating in the pulmonary microcirculation and tracheobronchial region. Peroxide and hydroxyl ions have been implicated as mediators in the increased microvascular permeability and pulmonary edema noted after inhalation injury. In this study we evaluated the use of an O2-free radical scavenger, dimethylsulfoxide (DMSO), and heparin in the treatment of smoke inhalation. Ewes (N = 26) that had been surgically prepared five days earlier were insufflated with smoke from burning cotton. There were four groups: controls (n = 7), DMSO (n = 6), heparin (n = 6), and DMSO plus heparin (n = 7). All animals were given ventilatory support to maintain their PO2above 60 mini Ig and their PCO2below 45 mml Ig. There was a significant difference in survival rates between groups. By 72 hours all seven of the control group were dead. All animals in the DMSO plus heparin group survived, four of the DMSO group died, and two of the heparin group died. Lung lymph flow was not as high in the DMSO plus heparin group as in the heparin-only group. DMSO was proved effective in reducing the lung injury associated with smoke inhalation.

ISSN:0273-8481    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The etiology of postburn circulatory impairment (“burn shock”) is multifactorial and incompletely understood. However, systemic vasoconstriction is a consistent observation during this period and occurs in spite of aggressive fluid resuscitation therapy. We studied the degree and time course of systemic vasoconstriction in goats for 24 hours following burns of two sizes (20% and 35% TBSA), in which fluid resuscitation was performed according to a common clinical crystalloid regimen. Cardiac index and urine output (reflecting renal perfusion) fell dramatically at two hours after burn, but returned slowly to preburn levels by 24 hours. The degree of fall and rate of recovery were dependent on burn size. Dermal perfusion was assessed by laser Doppler flowmetry in both burned and unburned skin. Dermal perfusion was negligible in burned skin. Unburned skin blood flow fell with increasing burn size, progressively recovered to preburn levels after the small burn, but at 24 hours remained significantly depressed after the larger burn. The stimulus for this persistent skin vasoconstriction is unclear.

ISSN:0273-8481    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The lipolytic capacity of patients with severe and moderate thermal injury was assessed in vivo by determining the rate of clearance of chylomicrons. Twelve patients, two women and ten men, age 34 ± 12 years, had burns varying from 28% to 84% of total burn surface area (TBSA). Seven patients had an average burn size of 63% TBSA. They were hypocholesterolemic and normotriglyceridemic during parenteral alimentation that excluded fat emulsion. But when Lyposil was infused intravenously (150 mg/kg/hr for a period of eight hrs), plasma triglyceride (TG) levels increased. Most of the triglyceride was in the form of chylomicrons, which had a prolonged residence time in plasma. Patients with moderate thermal injury (mean % TBSA 38% ± 9%) had normal TG levels before fat infusion. When Liposyl was infused intraduodenally (170 mg/kg/hr), the plasma TG levels remained normal and the chylomicron half-life was very short. These observations suggest that patients with severe thermal injury may have reduced lipolytic capacity, especially during parenteral administration of fat emulsion.

ISSN:0273-8481    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The addition of 1% chlorhexidine digluconate to 1% silver sulfadiazine cream (CDSS) was compared with 1% silver sulfadiazine (SS) alone to assess the antibacterial effect of a once-daily application of the therapies on an experimental rat model with a 20% full-thickness burn wound seeded with 108microorganisms originally isolated from infected wounds of burn patients. Separate series evaluatedStaphylococcus aureus, Psendomonas aeruginosa, Enterobacter cloacae, andStreptococcus faecalis. The mean concentration of all four organisms recovered after one week from biopsy specimens of full-thickness eschar was less in the CDSS-treated animals compared with the SS-treated animals. Microbial invasion into subjacent muscle was less frequent in animals seeded withS faecalis, while the mean concentration of bacteria recovered from muscle of animals seeded withS aureusandE cloacaewas less in animals treated with CDSS compared with those treated with SS (P< 0.05). he addition of 1% chlorhexidine digluconate to 1% silver sulfadiazine increased the antibacterial effectiveness of the latter agent.

ISSN:0273-8481    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Isolated coronary perfused guinea pig hearts were used to determine if aging alters left ventricular (LV) intrinsic contractile response to unresuscitated burn shock. We first compared control hearts from both young (N=10) and aged (N=10) guinea pigs. Compared with young control hearts, aged control hearts showed significantly lower left ventricular performance (LVP) (84.2 ± 1.6v76.0 ± 1.5;P<0.003), +dP/dtmax(1417.5 ± 52.4v1048 ± 48.7;P<0.001), and -dP/dtmax(1079 ± 79v916 ± 27;P<0.001) at a left ventricular end-diastolic pressure (LVEDP) of 10 mml-Ig. A 43% ± 2% third-degree burn (Walker model) was studied in 20 young and 10 aged guinea pigs. The aged burn hearts showed significantly lower LVP (57.1 ± 2.1v65.5 ± 2.0;P<0.01) and +dP/dtmax(1026 ± 66.4v1219 ± 59.9;P<0.001) at an LVEDP of 10 mm Hg. In addition, LV function curves for the aged burn hearts were shifted downward and to the right of curves obtained from the young burn hearts (P<0.05). Contractile defects in the aged group were neither related to altered beating frequency nor to maximally effective increases in diastolic stretch. While increased extracellular calcium concentration (from 1 to 8 millimolar [mM]) increased LVP, + dP/dtmax, and − dP/dtmaxin a dose-dependent manner in both young and aged burn hearts, absolute values of measured contractile performance were consistently less in the aged hearts compared with the young hearts at identical calcium concentrations. Finally, we examined the effects of thermal injury on contractile function within the aged group. Peak LVP and maximal rate of relaxation were uniformly decreased in all burn hearts compared with control aged hearts. The + dP/dtmaxwas not significantly altered by burn in this age group (burn: 1026 ± 66; control: 1048 ± 49). This study suggests that severe myocardial contractile changes resulting from a major thermal insult in subjects with already compromised hearts is likely a significant limiting factor in the response to burn shock.

ISSN:0273-8481    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

This study was designed to examine the effect of the storage configuration of skin and the ratio of tissue-to-storage medium on the viability of skin stored under refrigeration. Human skin specimens were stored in four physical configurations in RPMI 1640 tissue culture media at 4 °C. Skin was transferred to surgically created defects on nude mice after specific storage intervals. Grafts were examined grossly and microscopically after ten days.In the rolled configuration, on storage day 15, the viability of the outside of the roll was significantly better than the inside (P<0.01). The graft viability of the outside of the skin rolls was similar for both tissue-to-media ratios as well as for both free-floating configurations (P=0.27). These findings suggest the optimum cold storage configuration is free floating, and 300 cm2/100 ml, is an appropriate skin surface area to volume media ratio. This proportion of tissue to media is in agreement with the minimum ratio currently recommended by the Skin Council of the American Association of Tissue Banks.

ISSN:0273-8481    

出版商:OVID    

年代:1988

数据来源: OVID