FLUID RESUSCITATION FOLLOWING A BURN INJURY - IMPLICATIONS OF A MATHEMATICAL-MODEL OF MICROVASCULAR EXCHANGE

A validated mathematical model for microvascular exchange in thermally injured humans has been used to predict the consequences of different forms of resuscitation and potential modes of action of pharmaceutica ls on the distribution and transport of fluid and macromolecules in th e body. Specifically, for 10 and/or 50 per cent burn surface area inju ries, predictions are presented for no resuscitation, resuscitation wi th the Parkland formula (a high fluid and low protein formulation) and resuscitation with the Evans formula (a low fluid and high protein fo rmulation). As expected, Parkland formula resuscitation leads to inter stitial accumulation of excess fluid, while use of the Evans formula l eads to interstitial accumulation of excessive amounts of proteins. Th e hypothetical effects of pharmaceuticals on the transport barrier pro perties of the microvascular barrier and on the highly negative tissue pressure generated postburn in the injured tissue were als investigat ed. Simulations predict a relatively greater amelioration of the acute postburn edema through modulation of the postburn tissue pressure eff ects. (C) 1997 Elsevier Science Ltd for ISBI.