[Disorders of the ventilation-diffusion correlations and of the gas-transport function of the blood in the acute period of burn trauma in children].

External respiration and blood gas composition were examined in 187 children aged 1 to 14 years during the acute period of burn disease (burn shock and toxemia). The patients were divided into three groups with different area of thermal injury to the skin. Group 1 were children with burns of up to 10% of body surface area. The ventilation parameters in this group were changed just negligibly, and the diffusion capacity of the lungs and gas composition of arterial blood were within the normal range of values both during shock and toxemia. In patients with burns involving 11 to 20% of body surface the ventilation parameters were changed appreciably and did not compensate for each other, as was observed in group 1. The diffusion capacity of the lungs and blood gas composition values were moderately decreased. During toxemia the minute-consumption of oxygen was decreased and alveolar oxygen tension remained unchanged. As a result of this, the diffusion capacity of the lungs and blood gas parameters continued to decrease. The most dynamic changes were observed in children with burns involving 21 to 45% of body surface. The ventilation-diffusion disorders and blood gas composition were altered, particularly so during toxemia; the changes consisted in a decrease of the minute ventilation volume and oxygen tension in arterial blood and a moderate increase of alveolar oxygen tension, which led to further decrease of the diffusion capacity of the lungs. In parallel with the disorders in the above parameters, x-ray changes in the lungs were observed, which were characterized by a vascular-interstitial pattern in group 2 and infiltrative changes in group 3. In children with burn wounds of 35 to 45% of body surface these changes presented as the developing lung edema.