NONINVASIVE ASSESSMENT OF INTERCOMPARTMENTAL FLUID SHIFTS IN BURN VICTIMS

Two non-invasive methods (the bioimpedance technique, BIA, and the imp ression method, IM) were studied, to find out whether they are sensiti ve enough to detect and chronicle the development of the oedema and fl uid resuscitation effects (Parkland formula) that occur secondary to a major burn, Ten patients with a total burned body surface area (TBSA) of more than 10% were included in this prospective study. Total body water (TBW), as measured by the resistance (BIA) or F(0) variable (IM) , reached a maximum on day 2, The tissue fluid translocation (INT) var iable (IM) followed a different course, increasing slowly to reach a m aximum on day 6, when it was 40% higher than the 12 h value. TBW and t he interstitial translocatable fluid were still increased 1 week post- burn. The non-invasive measurements of TBW (resistance by BIA and F(0) by IM) reflected the anticipated changes in TBW. The phase angle (BIA ) indicative of cellular membrane effects of burn and sepsis had its l owest values at day 1.5, and stayed significantly low until day 4, Int erestingly, the phase angle was lowest in the two cases that died subs equently. The different time course of the INT value (IM), which refle cted the translocatable interstitial fluid volume in skin, may be the result of resuscitation fluid remaining in this compartment, due to th e excess sodium content together with a possible change in tissue comp liance secondary to the early total water peak on day 2. (C) 1998 Else vier Science Ltd for ISBI. All rights reserved.