“…Simultaneously, during the early period of burn disease, a decrease in cardiac output occurs, that cannot be influenced by sufficient volume supply [9]. This is possibly induced by circulating humoral factors like tumor necrosis factor (TNF), endothelin-1, interleukins or free oxygen radicals with a significant negative inotropic effect, as well as by a decreased response to endogenous catecholamines and a diminished coronary blood flow [4,6,11,13,14]. Paralleling the decrease in cardiac output, peripheral vascular resistance increases.…”