COMPARISON OF THE POSTBURN HYPERDYNAMIC STATE AND CHANGES IN LUNG-FUNCTION (EFFECT OF WOUND BACTERIAL CONTENT)

  • 1 November 1986
    • journal article
    • research article
    • Vol. 100  (5) , 828-835
Abstract
The pulmonary and systemic response to a full-thicknes burn (15% of total body surface area) was determined in 15 adult sheep. Also compared was the effect of wound bacterial content and prostanoid release on this response. Burn wound thromboxane A2, measured as TxB2, and prostacyclin, measured as 6-keto-PGF1.alpha., were measured in burn wound lymph. Animals were monitored for 7 days. On the final day, a full-thickness biopsy specimen of burn tissue was obtained for quantitative bacteriology. Wounds with 104 or less organisms per gram fo burn tissue were considered colonized, whereas those with 105 or more organisms per gram of burn tissue indicated wound infection. Seven sheep had 104 or less bacteria and the remaining eight sheep had 106 or greater bacteria. We noted a significant mean increase in cardiac index from a baseline of 5 to 6.2 L/min/m2, a decrease in systemic vascular resistance from 16 to 12 mm Hg/L/min, and a mean increase in oxygen consumption from a baseline of 135 to 165 ml/min/m2 during the 7-day study period. There were no differences in these responses between the colonized and the infected wounds. Pulmonary artery pressure increased from a mean baseline of 19 to 24 mm Hg and arterial oxygen tension (PaO2) decreased from a baseline of 90 to 80 mm Hg in the infected wound group, with values remaining at baseline in the colonized wound group. These changes corresponded with an increase in lymph and plasma TxB2 from a baseline of 200 and 210 pg/ml to 1000 .+-. 250 and 600 .+-. 190 pg/ml, respectively. Values in the animals with colonized wounds were not significantly increased. We concluded that wound bacterial content as measured by a quantitative culture did not alter the hyperdynamic postburn response, although infected wounds did appear to produce modest pulmonary abnormalities and an increased production of TxB2.