PMID- 29757442 OWN - NLM STAT- MEDLINE DCOM- 20200226 LR - 20200226 IS - 1559-0488 (Electronic) IS - 1559-047X (Linking) VI - 39 IP - 5 DP - 2018 Aug 17 TI - Effect of Intravenous Fluid Volumes on the Adrenal Glucocorticoid Response After Burn Injury in Swine. PG - 652-660 LID - 10.1093/jbcr/iry024 [doi] AB - Severe thermal injury induces metabolic and physiological stress, prompting a disruption in the hypothalamic-pituitary-adrenal axis. The objective of this study was to evaluate potential confounding effects of Lactated Ringer's (LR) resuscitation on adrenal damage and cortisol production following burn. Anesthetized swine were instrumented with jugular catheters and sustained 40% TBSA burns from brass probes heated to 100 degrees C. Animals recovered to consciousness and received IV fluid resuscitation with LR at two different volumes: 15 ml/kg/d (limited volume [LV], n = 6) or 2 ml/kg/%TBSA/d (modified Brooke [MB], n = 6). Nonburned animals (Sham) were both oral and IV fluid restricted (S-FR, n = 4) to induce stress. Computed tomography (CT) angiographies were performed at baseline (BL) and 48 hours postburn, while blood and urine samples were collected at BL, 6, 24, and 48 hours postburn, with euthanasia at 48 hours for adrenal harvesting. Urinary cortisol was elevated following burn/surgery in all animals and returned back to BL in S-FR (404 +/- 48 pg/mg creatinine) but not MB (1332 +/- 176 pg/mg creatinine; P = .005) or LV (1223 +/- 335 pg/mg creatinine; P = .07) by 48 hours. Gene expression of cleavage enzymes (3beta-HSD, CYP17, CYP11, and CYP21) along the cortisol synthesis pathway showed minimal changes. Adrenal apoptosis (Terminal deoxynucleotidyl transferase dUTP nick-end labeling [TUNEL] staining) was greatest in the MB group (P