Word: fluid
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Dates: during 1990-1999
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...Shander, 49, an Israeli-born physician who majored in Asian languages as an undergraduate, is passionate about anything, it is blood. Not only because it is, as Goethe observed, "a very special juice," the fluid pumped by our hearts through arteries, veins and capillaries, and without which the body's cells would be starved of oxygen and nutrients; nor only because he knows blood transfusions save lives; nor simply because 70% of those transfusions are administered by anesthesiologists...
...suctioned out by cell-saving machinery, cleaned and then returned to the patient's body. Red blood cells can also be saved through hemodilution. In this procedure, hemoglobin-rich blood is pumped unit by unit from a vein and replaced by an equal number of units of a nonblood fluid to expand the volume to normal; the patient's own drawn blood is held for use after surgery. In another technique, doctors may use albumin, a protein found in plasma that is acceptable to many who refuse transfusions on religious grounds, to maintain or increase blood volume, or to manage...
Another major concern is the loss of fluid. When deep burns cover a large area of the body and the skin no longer provides an effective barrier against infection, the immune system goes into overdrive to ward off invading germs. It floods the injured areas with blood and plasma carrying immune cells, which cause extensive inflammation and swelling. In some cases the swelling is severe enough to interfere with breathing, and the patient must be put on a ventilator...
...massive immune response can also cause fluid to leak from blood vessels throughout the body. This leads not only to dehydration and deterioration of vital organs but also to a dangerous drop in blood pressure, which can result in shock. Indeed, many patients admitted to burn units are already in shock and unable to feel the pain that would be overwhelming if they were conscious...
Even when a patient is conscious, though, the burn team must focus first not on painkillers but on stabilizing the blood pressure. The New York team accomplishes this by pumping as much as 8 gal. of a salt fluid into his veins in the first 24 hours of treatment, a process that can cause the patient temporarily to gain as much...