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The effects of burns on the renal 642x361_RCC ((the major complications of…
The effects of burns on the renal
(the major complications of burns on kidney)
Fluid shift and hypovolaemia
inducing oliguria early after burns
Sodium retention in collagen fibres and sodium-potassium pump impairment cause oedema
Increased vascular permeability
Excess free water given in this period lowers the tonicity of plasma
reduce blood flow and fluid loss cause renal hypoperfusion
Excessive myolobin
tubular obstruction and acute kidney injury
myoglobin release into circulation due to muscle destruction
monomer contain heme molecule can precipitate
Stress-related hormones
cause vasoconstriction and fluid retention as well as alteration of regional blood flow, especially in the kidney
plasma atrial natriuretic polypeptide (ANP) levels are elevated for sustained periods after burns
elevated levels of catecholamines, angiotensin II, aldosterone, and vasopressin
ANP counterbalances the actions of the stress-related hormones through vasodilatation and natriuresis
Excessively high levels of stress-related hormones and/or impairment of ANP secretion may participate in reducing renal function
The effects of burns on the digestive systems
Acute pancreatitis
trigger pancreatic injury and bacteremia
cause infection in injured pancreas
pancreatic ischemia occur after burn
lead to development of postburn acute pancreatitis
Acute Acalculous Choleocystitis
effect the perfusion of gallbladder (ischemia-reperfusion injury)
favor bile stasis lead to injury and inflammation
inflammatory disease of the gallbladder
acute gastric dilation
predispose to acute gastric dilatation
cause disruption of blood supply to the stomach
Curling's ulcer
burn cause less blood supply to intestine
cell begin to die
formation of ulcer in duodenum
paralytic ileus
less of blood volume due to hypovolemia
less blood supply to intestine muscle
obstruction of intestine (paralysis of intestine muscle)
Abdominal compartment syndrome
increase in intra abdominal pressure(IAP)
reduce blood flow to abdominal organ
multi organ dysfunction and necrosis
IAP occur in
ascites
severe gut oedema
major fluid resuscitation
