Vascular manifestations of extensive thermal skin injury in rat mesentery
After 40% body surface area skin burns, mesenteric microcirculation revealed initially augmented vasomotion and increased epinephrine responsiveness. Lowered precapillary epinephrine thresholds persisted throughout the terminal phase of early fatalities. Animals surviving 48 hr went through a phase with elevated epinephrine thresholds. Venodilatation coexisted with precapillary constriction. Initially most capillaries were empty; a few were dilated and congested with sluggish blood flow, indicating stasis. Lowered epinephrine responsiveness appeared first on the venous side coincident with apparent relief of stasis. Whitish aggregates or "clots" were frequently observed in circulation, but sludging or red cell agglutination was virtually absent. Morphologically the small blood vessels revealed endothelial swelling and there was a tendency for leukocytes to adhere to the vessel wall, the latter feature being more pronounced in later stages of burn shock. Other hemodynamic data indicated general peripheral vasoconstriction which gradually subsided in recovering animals. The circulatory changes are not consistent with circulating "burn toxins" impairing vascular contractility but with disruption of local control of vascular smooth muscle responsiveness, resulting in decompensatory venodilatation.