THE ANEMIA OF THERMAL INJURY. I. STUDIES OF PIGMENT EXCRETION 12

Abstract

Urine and fecal excretion of urobilinogen and urine coproporphyrin were detd. in 17 burn patients over long periods of hospitalization. These were correlated with complete hematologic studies including blood volumes. Increased excretion of urine and fecal urobilinogen occurs just after the injury and lasts for several days. In severe burns this may be marked, and continues for long periods. In less severe burns, increased pigment excretion is followed by decreased pigment excretion, and suggests decreased pigment catabolism. The hemolytic index follows this same trend. Urine coproporphyrin rises for several days after the burn, maintains an elevated plateau, and returns to normal when healing is complete. Oral aureomycin prevents urobilinogen formation in the bowel, but small quantities of Ehrlich reacting substances are still present. There is no effect on urine coproporphyrin excretion. These observations are interpreted as evidence that the anemia of thermal burns is first hemolytic, then dyshemopoietic.