PMID: 3770929Sep 1, 1986Paper

Controversies in the fluid management of post-traumatic lung disease

Injury
D H Wisner, J A Sturm

Abstract

The appropriate intravenous therapy for injured patients is controversial. Use of colloid-containing solutions has been advocated in an attempt to maintain intravascular colloid osmotic pressure, minimize pulmonary oedema and draw fluid out of areas of contused lung. Studies of animals with lymph fistulas in the lung do not support such therapy and there is no difference between lung water volumes in animals resuscitated for 3 hours with colloid as opposed to crystalloid solutions after a standardized traumatic insult (colloid = 8.4 + 0.8 ml/kg; crystalloid = 7.5 + 0.6 ml/kg). Increased pulmonary capillary permeability makes such therapeutic attempts to 'dry out' the lungs even less effective. Studies in human patients of the rate of extravasation of labelled albumin from the pulmonary intravascular space indicate that increased permeability of pulmonary capillaries occurs early after injury and remains elevated in many severely injured patients. Low plasma colloid osmotic pressures do not correlate with increases in extravascular lung water. A shift to the use of vigorous crystalloid resuscitation of injured patients at our institution has resulted in decreases in both mortality rate (1976-1979, 35 per cent; 1979-1981, 28 per ...Continue Reading

References

Aug 1, 1979·Circulation Research·K L BrighamJ Haynes
Oct 1, 1979·The Journal of Surgical Research·F R LewisJ A Sturm
Feb 1, 1975·The Journal of Surgical Research·J W Holcroft, D D Trunkey
Nov 1, 1981·Circulation Research·G C KramerR H Demling

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Citations

Mar 5, 2009·Critical Care : the Official Journal of the Critical Care Forum·Charles R PhillipsMartin A Schreiber
Sep 11, 2014·Der Anaesthesist·M RoesslerM Bauer
Jan 12, 2010·Current Opinion in Anaesthesiology·Maarten Jlj van den ElsenJozef Kesecioglu
Apr 12, 2008·The Veterinary Clinics of North America. Small Animal Practice·Sophie Adamantos, Dez Hughes
Dec 22, 1999·The Journal of Laryngology and Otology·S P Dubey, J P Garap
Oct 3, 1999·The Journal of Laryngology and Otology·B MukherjeeY Bajaj
Apr 1, 1994·The Journal of Laryngology and Otology·G E MurtyK P Gibbin

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