Visceral Blood Flow Following Thermal Injury

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Abstract
To determine if visceral blood flow was altered by thermal injury, effective renal blood flow (ERBF) was measured by p-aminohippurate clearance in 5 control subjects and 13 nonbacteremic burn patients (mean burn size: 50% total body surface, range: 24.5-83.5) 6-25 days after burn injury. Splanchnic blood flow (SBF) and cardiac output were determined in a matched group of 10 patients by indocyanine green clearance and dilution techniques, respectively. Renal and splanchnic O2 consumptions (.ovrhdot.VO2) were calculated from regional arteriovenous O2 differences and blood flows. ERBF was not significantly elevated in these patients (780 .+-. 68 ml/min per m2, mean .+-. SE, vs. 552 .+-. 37 in controls). SBF, at 1463 .+-. 96 ml/min per m2 was twice normal and 19% of cardiac index (7764 .+-. 393 ml/min per m2). Individual variations in ERBF and SBF were unrelated to burn size or time after injury but ERBF varied with 24 h Na excretion. Renal and splanchnic .ovrhdot.VO2 were twice normal levels at 33 .+-. 6 and 66 .+-. 4 ml/min, respectively. Increase in ERBF was not an obligatory response to burn injury but dependent on Na load and/or vascular volume. SBF was consistently increased by thermal injury and contributed to rise in cardiac output after injury. While increase of SBF was appropriate for rise in local .ovrhdot.VO2, the cause of apparent splanchnic vasodilation was unknown.