What physiological effects do burn wounds have on the different organ systems of the body?
At the site of the burn tissue necrosis occurs, leading to the breakdown of capillary enothelial integrity. This results in the leakage of fluid, electrolytes and protein from the intravascular space. The most dramatic losses occur within the first 12 hours. This may result in hypovolemia, leading to decreased cardiac output. Red blood cells may be hemolyzed by the burns or by passing through the damaged capillaries and DIC may result. Hypovolemia may lead to decreased renal profusion and oliguria. This combined with hemoglobinuria and myoglobinuria contribute to the development of acute renal failure. Reduced albumin and loss of immunoglobulins into the wound can lead to decreased immunity. Liver dysfunction occurs due to congestion and necrosis, which also predisposes to immunosuppression and septicemia. • How would you treat the hypovolemic shock? During the first 24 hours a balanced electrolyte crystalloid solution is recommended. You want to avoid pulmonary or burn tissue edema. A
