Document Detail


The effects of topical epinephrine on haemodynamics and markers of tissue perfusion in burned and non-burned patients requiring skin grafting.
MedLine Citation:
PMID:  19481869     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the systemic effects in burn and non-burn patients undergoing skin grafting with or without the use of topical epinephrine to control bleeding. BACKGROUND: The effects of topical epinephrine on haemodynamics and bleeding are principally documented with burn patients. No reports are available on the effects of topical epinephrine on non-burn patients especially on markers of tissue perfusion. MATERIAL AND METHODS: A prospective study where topical epinephrine was used on burn and non-burn patients and five patients served as controls without epinephrine usage. Catecholamine concentrations were measured and to estimate the systemic effects of epinephrine, serum lactate and pyruvate concentrations were analyzed and perioperative haemodynamic changes recorded. RESULTS: Compared to the baseline values, there was a significant increase in the heart rate, serum epinephrine and lactate concentrations and LP-ratios in the burn patients and an increase in the epinephrine concentrations in the non-burn patients at 1 and 2 h. Epinephrine and lactate concentrations and LP-ratios were also higher in the burn patients compared to the other groups. Altogether, there were no changes in the control group. CONCLUSION: This study showed that the use of topical epinephrine has systemic effects on haemodynamics and serum epinephrine concentrations. Increased epinephrine concentrations in burn patients suggest increased absorption properties in these patients. The increased lactate concentrations and LP-ratios suggest tissue ischaemia, likely in skin.
Authors:
Anthony A Papp; Ari V Uusaro; Esko T Ruokonen
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2009-05-30
Journal Detail:
Title:  Burns : journal of the International Society for Burn Injuries     Volume:  35     ISSN:  1879-1409     ISO Abbreviation:  Burns     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-07-31     Completed Date:  2009-10-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8913178     Medline TA:  Burns     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  832-9     Citation Subset:  IM    
Affiliation:
BC Professional Firefighters' Burn Unit, Vancouver General Hospital, Vancouver, BC, Canada. anthony.papp@ubc.ca
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MeSH Terms
Descriptor/Qualifier:
Administration, Cutaneous
Adolescent
Adult
Aged
Biological Markers / blood
Blood Loss, Surgical / prevention & control
Burns / physiopathology,  surgery*
Child
Child, Preschool
Epinephrine / blood,  pharmacology*,  therapeutic use
Female
Heart Rate / drug effects
Hemodynamics / drug effects*
Humans
Lactic Acid / blood
Male
Middle Aged
Prospective Studies
Skin Transplantation*
Stimulation, Chemical
Vasoconstrictor Agents / blood,  pharmacology*,  therapeutic use
Young Adult
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Vasoconstrictor Agents; 50-21-5/Lactic Acid; 51-43-4/Epinephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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