Effects of hypertonic saline dextran resuscitation on oxygen delivery, oxygen consumption, and lipid peroxidation after burn injury.
We compared the effects of lactated Ringer's (LR) and hypertonic saline dextran (HSD) on postburn cardiovascular function, O2 consumption, lipid peroxidation, and bacterial translocation. Miniature pigs with 40% total body surface area (TBSA), third-degree burns received, 30 minutes postburn, either Parkland resuscitation (LR group, n = 8) or HSD, 10 mL/kg/30 minutes, followed by LR, 4 mL/kg/%burn over the next 23 hours (HSD group, n = 8). The HSD prevented the early decrease in cardiac index (CI); the early increase in the resistance of the systemic, mesenteric, celiac, and renal vascular beds; and the decrease in mesenteric O2 consumption seen after burns when LR alone is used for resuscitation. The HSD also moderated the systemic and mesenteric lipid peroxidation. Bacterial translocation was less in the HSD group (3 of 8 animals) compared with the LR group (5 of 8 animals), but was not statistically different. Hypertonic saline dextran may be beneficial in improving the postburn microcirculation and attenuating postburn oxidant-induced lipid peroxidation in the systemic tissues and the gut.
Tokyay
R
R
Department of Surgery, University of Texas Medical Branch, Galveston.
Zeigler
S T
ST
Kramer
G C
GC
Rogers
C S
CS
Heggers
J P
JP
Traber
D L
DL
Herndon
D N
DN
D000818:Animals; D001419:Bacteria / Q000187:drug effects; D001784:Blood Gas Analysis; D002056:Burns / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000592:standards; D002465:Cell Movement / Q000187:drug effects; D015169:Colony Count, Microbial; D003911:Dextrans / Q000494:pharmacology / Q000627:therapeutic use*; D004195:Disease Models, Animal; D004353:Drug Evaluation, Preclinical; D004966:Estrogens, Conjugated (USP); D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D007552:Isotonic Solutions / Q000494:pharmacology / Q000627:therapeutic use*; D015227:Lipid Peroxidation / Q000187:drug effects*; D008643:Mesentery / Q000098:blood supply / Q000187:drug effects; D008833:Microcirculation / Q000187:drug effects; D010101:Oxygen Consumption / Q000187:drug effects*; D012079:Renal Circulation / Q000187:drug effects; D015427:Reperfusion Injury / Q000097:blood / Q000209:etiology; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic / Q000494:pharmacology / Q000627:therapeutic use*; D013152:Splanchnic Circulation / Q000187:drug effects; D013552:Swine; D013556:Swine, Miniature; D014655:Vascular Resistance / Q000187:drug effects
D003911:Dextrans; D004966:Estrogens, Conjugated (USP); D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic