Navar P D, Saffle J R, Warden G D
Am J Surg. 1985 Dec;150(6):716-20. doi: 10.1016/0002-9610(85)90415-5.
The presence of inhalation injury has been reported to increase fluid requirements for resuscitation from burn shock after thermal injury. To evaluate the effect of inhalation injury on the magnitude of burn-induced shock, the characteristics of resuscitation of 171 patients with burns covering at least 25 percent of the total body surface area were reviewed. When inhalation injury was suspected, confirmation by xenon-133 scanning, bronchoscopy, or both was obtained. Initial fluid resuscitation was calculated according to the Parkland formula, and titration was initiated to maintain a urine output of 30 to 50 ml/hour. Fifty-one patients had inhalation injuries. Patients with inhalation injuries had a mean fluid requirement of 5.76 ml/kg per percentage of total body surface area burned and a mean sodium requirement of 0.94 mEq/kg per percentage of total body surface area burned to achieve successful resuscitation, compared with a fluid requirement of 3.98 ml/kg per percentage of total body surface area burned and a sodium requirement of 0.68 mEq/kg per percentage of total body surface area burned for the group without inhalation injury (p less than 0.05). These data confirm and quantitate that inhalation injury accompanying thermal trauma increases the magnitude of total body injury and requires increased volumes of fluid and sodium to achieve resuscitation from early burn shock.
据报道，吸入性损伤的存在会增加热损伤后烧伤休克复苏所需的液体量。为了评估吸入性损伤对烧伤诱导休克严重程度的影响，我们回顾了171例烧伤面积至少占体表面积25%患者的复苏特征。当怀疑有吸入性损伤时，通过氙-133扫描、支气管镜检查或两者来确诊。初始液体复苏根据Parkland公式计算，并开始滴定以维持尿量在每小时30至50毫升。51例患者有吸入性损伤。有吸入性损伤的患者每烧伤体表面积百分比成功复苏所需的平均液体量为5.76毫升/千克，平均钠需求量为0.94毫当量/千克，而无吸入性损伤组每烧伤体表面积百分比的液体需求量为3.98毫升/千克，钠需求量为0.68毫当量/千克（p<0.05）。这些数据证实并量化了热创伤伴发的吸入性损伤会增加全身损伤的严重程度，需要增加液体和钠的量才能从早期烧伤休克中复苏。
