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Colloid infusions reduce glomerular filtration in resuscitated burn victims
D C Gore1, J M Dalton, T W Gehr
1Department of Surgery, Medical College of Virginia, Richmond, Virginia, USA.
The Journal of Trauma
|March 1, 1996
Summary
Colloid infusions like albumin expand plasma volume in burn patients but reduce glomerular filtration. Hormonal regulation of blood volume remains intact following burn injury.
Area of Science:
- Nephrology
- Endocrinology
- Trauma Surgery
Background:
- Colloids are clinically used to manage edema.
- However, colloids may negatively impact glomerular filtration.
- Assessing renal and hormonal effects of colloid use in burn resuscitation is crucial.
Purpose of the Study:
- To evaluate the renal effects of colloid supplementation during burn patient fluid resuscitation.
- To assess the hormonal responses to colloid administration in burn victims.
- To understand the impact of colloids on glomerular filtration and hormonal regulation post-burn.
Main Methods:
- Analytic cohort study.
- Six burn patients (30-57% total body surface area burn) received Ringer's lactate for initial resuscitation.
- Inulin and p-aminohippuric acid infusions were administered, followed by albumin (25% solution, 3 mL/kg/h) for 4 hours.
Main Results:
- Albumin infusion increased plasma volume by 37%.
- Glomerular filtration rate significantly decreased by 32% (p < 0.05).
- Aldosterone and plasma renin activity levels were normalized by albumin-induced plasma volume expansion.
Conclusions:
- Colloid infusions, while expanding plasma volume, reduce glomerular filtration and may limit diuresis.
- Hormonal regulation of blood volume remains functional after moderate burn injury.
- These findings highlight the complex renal and hormonal interplay during burn resuscitation with colloids.