Bert J L, Bowen B D, Reed R K, Onarheim H
Department of Chemical Engineering, University of British Columbia, Vancouver, Canada.
Circ Shock. 1991 Jul;34(3):285-97.
The present work is a continuation of studies concerned with mathematical modelling and simulation of microvascular fluid and protein exchange following burn injuries [Bert et al.: Circulatory Shock 28: 199-219, 1989: Bowen et al.: Circulatory Shock 28: 221-233, 1989]. The model has been extended to include the effects of different types of fluid resuscitation on the circulatory and microvascular exchange systems. The model and a statistical fitting procedure were used to find the ranges of fitting parameter values that best describe the changes in interstitial fluid volume and protein mass as well as transcapillary protein extravasation for three sets of experiments (no resuscitation, resuscitation with Ringer's or resuscitation with plasma). Typical changes in mass exchange related parameters postburn that resulted in simulation predictions which were a good fit to the experimental data include: an increase in the large pore pathway for protein of 100 times in the injured skin and 5 times in non-injured skin and skeletal muscle, an increase in fluid filtration coefficients in injured skin of 10 times and an instantaneous decrease of 50% in the area available for exchange in injured skin at the time of the burn.
本研究是关于烧伤后微血管液体和蛋白质交换的数学建模与模拟研究的延续[Bert等人：《循环休克》28：199 - 219，1989年；Bowen等人：《循环休克》28：221 - 233，1989年]。该模型已得到扩展，纳入了不同类型液体复苏对循环和微血管交换系统的影响。利用该模型和一种统计拟合程序来找出拟合参数值的范围，这些参数值能最好地描述三组实验（未复苏、林格氏液复苏或血浆复苏）中组织间液体积和蛋白质质量的变化以及跨毛细血管蛋白质外渗情况。烧伤后质量交换相关参数的典型变化导致模拟预测结果与实验数据高度吻合，这些变化包括：受伤皮肤中蛋白质的大孔通道增加100倍，未受伤皮肤和骨骼肌中增加5倍；受伤皮肤中液体滤过系数增加10倍；烧伤时受伤皮肤可用于交换的面积瞬间减少50%。
