COLLOID INFUSIONS REDUCE GLOMERULAR-FILTRATION IN RESUSCITATED BURN VICTIMS

Objective: Colloids are used clinically to minimize edema yet may have detrimental consequences on glomerular filtration, The purpose of thi s study is to assess the renal and hormonal effects of colloid supplem entation in the fluid resuscitation of burn victims, Design: Analytic cohort study, Material and Methods: Immediately following their 24 hou r post-burn fluid resuscitation with Ringer's lactate, six burn patien ts (% total body surface area burn 30-57%) were given primed, continuo us infusions of inulin and p-aminohippuric acid for 6 hours, Albumin ( 25% solution, 3 mL/kg/h) was given for the final 4 hours of study, Mea surements and Main Results: Albumin infusion increased plasma volume b y 37%; however, glomerular filtration rate decreased by 32% (p < 0.05) , There was no significant change in urine output, sodium excretion, o r effective renal plasma now, Plasma volume expansion with albumin nor malized elevated basal levels of aldosterone and plasma renin activity , Conclusions: These findings illustrate that despite substantially in creasing plasma volume, colloid infusions reduce glomerular filtration and may limit any associated diuresis, Furthermore, this study demons trates that hormonal regulation of blood volume remains intact after m oderate burn injury.