Aharoni A, Moscona R, Kremerman S, Paltieli Y, Hirshowitz B
Haifa Medical Center, Israel.
Burns. 1989 Oct;15(5):281-4. doi: 10.1016/0305-4179(89)90001-6.
The occurrence of the adult respiratory distress syndrome (ARDS) and pneumonia was assessed in 482 patients with severe burns, but without evidence of inhalation injury. The patients were resuscitated during the burn shock period with a low-volume formula consisting mainly of plasma. The incidence of ARDS was 2.5 per cent for the entire burn population, and 9.4 per cent for 65 patients with burns covering more than 50 per cent of the body surface area. The general incidence of pneumonia was 4.4 per cent but was 12.5 per cent for the 65 patients with the extensive burns. These incidences were compared with other studies, and a pathophysiological explanation has been offered to explain differences in the frequency of pulmonary complications. The present review indicates that resuscitation with a low-volume formula consisting mainly of colloids can act as prophylaxis for reducing the incidence of ARDS and pneumonia.
对482例重度烧伤但无吸入性损伤证据的患者评估了成人呼吸窘迫综合征(ARDS)和肺炎的发生情况。在烧伤休克期,患者采用主要由血浆组成的小容量配方进行复苏。整个烧伤人群中ARDS的发生率为2.5%,而65例烧伤面积超过体表面积50%的患者中,发生率为9.4%。肺炎的总体发生率为4.4%,但在65例大面积烧伤患者中为12.5%。将这些发生率与其他研究进行了比较,并提供了一种病理生理学解释来解释肺部并发症发生频率的差异。本综述表明,采用主要由胶体组成的小容量配方进行复苏可作为预防措施,以降低ARDS和肺炎的发生率。