The Use of Diuretics in the Treatment of Early Wet Lung Syndrome

Fleming, William H.; Bowen, John C.

doi:10.1097/00000658-197204000-00008

Cited by 22 publications

(2 citation statements)

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“…As a result, massive volumes of crystalloid solutionsnota-bly Ringer's lactatebecame widely favored for the treatment of a blood or plasma volume loss. Clinical experience now suggests that the resulting acute hypoproteinemic fluid overload may not be innocuous, but variable effects have been recorded following treatment with diuretics alone [5], concentrated albumin only [24], or both agents in combination [7,23,241. Recent physiological research has, in principle, confirmed Starling's [26] hypothesis with certain refinements [3,8,301, but a controlled experimental study simulating clinical infusion therapy has, to our knowledge, not been performed.…”

Section: Introductionmentioning

confidence: 99%

Acute Hypoproteinemic Fluid Overload: Its Determinants, Distribution, and Treatment with Concentrated Albumin and Diuretics

et al. 1977

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We simulated the use of massive volumes of crystalloid fluids as a treatment of acute plasma loss in a standardized experimental model and studied the factors determining the retention or excretion of the resulting acute hypoproteinemic fluid overload, its distribution within the body, and its treatment with concentrated albumin and diuretics. In accordance with the classic Starling concept, the serum protein level, i.e. the serum colloid osmotic pressure, determined the excretion/retention ratio of a given water and sodium load. Of the total fluid retention, fat and muscle each accommodated 25%, whereas the skin, which contributes only 7% to the total body weight, accounted for 37% and increased its volume by roughly one third. Concentrated albumin promoted fluid excretion in direct proportion to the achieved increment of the serum protein level and abolished the edema of fat, muscle and skin. Furosemide was virtually ineffective. The implications of these results for the 'adult respiratory distress syndrome' and disturbed wound healing are discussed and related to the concept of a critical threshold of the serum protein level.

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Section: Introductionmentioning

confidence: 99%

Acute Hypoproteinemic Fluid Overload: Its Determinants, Distribution, and Treatment with Concentrated Albumin and Diuretics

et al. 1977

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“…appeal was raised for moderation in the use of buffered saline solution in patients (Moore, F. D. and Shire, S. T., 1967). Serious morbidity and even mortality were reported following the overenthusiastic use of large volumes of isotonic or hypotonic balanced saline solutions in pre-operative, operative and post-operative patients, as this was found to induce interstitial pulmonary edema (Frank, E. D. 1969;Fleming, W. H. and Bowen, J. C. 1972). Monafo, Wm.…”

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confidence: 99%