Lung water changes after XXXX . The effects of crystalloid resuscitation and @entity295 .

@entity1 @entity295 @entity3126 @entity4 @entity1017 @entity1576 @entity9427 @entity58573 @entity130
@entity1576 after @entity130 is common, but the etiologic roles of high volume crystalloid resuscitation, @entity9427 , @entity130 , or @entity295 have not been specifically defined in @entity1 studies. We used the thermal-green dye double indicator dilution measurement of extravascular lung water (EVLW) to follow daily lung water changes in seven severly burned adult @entity1 , resuscitated with only crystalloid solutions. An average @entity1017 of 21.3 kg, a 30% increase (p < 0.001), was present two to three days after admission. Admission EVLW for all @entity1 was 7.9 +/- 1.2 ml/kg, (means +/- SD), and EVLW at the time of maximal @entity1017 was 5.9 +/- 1.4 ml/kg, a 25% decrease (p < 0.05). Admission pulmonary artery wedge pressure ( @entity58573 ) was 8 +/- 3 mmHG, which was not significantly different from @entity58573 of 13 +/- 4 mmHg at the time of maximal @entity1017 . In the three @entity1 who died of @entity295 , their terminal weight averaged 17.8 kg (27%) above their admitting weight (p < 0.01) and EVLW was 26.4 +/- 4.4 ml/kg, a 200% increase (p < 0.02) from admission. Their terminal @entity58573 averaged 22 +/- 2 mmHg, a 170% increase (p < 0.005). None of these @entity1 had an increase in EVLW until clinical signs of @entity295 occurred and the rise in EVLW preceded the rise in @entity58573 . Calculated mean plasma colloid osmotic pressure (PCOP) on admission was 20.7 +/- 4.9 mmHg; at the time of maximal @entity1017 , it was 8.6 +/- 1.7 mmHg (p < 0.001). The @entity58573 gradient fell to -4 +/- 4 mmHg (p < 0.001) at the time of maximal @entity1017 and remained less than +4 mmHg throughout the study period in all @entity1 . We conclude that massive crystalloid resuscitation while maintaining @entity58573 below 15 mmHg does not cause an increase in EVLW during the first four days after @entity130 . EVLW actually decreases slightly in all @entity1 despite marked @entity1017 , @entity9427 and a negative @entity58573 gradient. EVLW does not correlate with the @entity58573 gradient in either septic or nonseptic periods. Three @entity1 had severe @entity130 and normal EVLW for the first four postburn days. It therefore appears that significant @entity4 does not result from @entity130 . There is also no evidence that @entity130 causes an early increase in pulmonary capillary permeability. The occurrence of @entity295 , however, results in rapid accumulation of lung water, without any change in hydrostatic or osmotic forces. This study supports the primary role of @entity295 in altering pulmonary capillary permeability with resulting @entity3126 .
