Optimal composition of burn resuscitation fluids.
The hemodynamic, renal, and hematologic responses to fluid resuscitation with four different hydrating solutions (lactated Ringer's and hypertonic salt solutions, with and without albumin) administered in equal quantities were compared in an ovine burn model. Forty-five animals, including a sham group, were studied. The burn (40%, flame) was inflicted under anesthesia, but the animals were then studied while in the awakened state. Fluid resuscitation was begun one hour after the burn. While all animals survived the burn and disclosed reasonable hemodynamic stability throughout the experiment, those that received lactated Ringer's with albumin (LRA) restored their cardiac output to preburn values, by 24 h postinjury demonstrated higher serum albumin and colloid osmotic pressure levels, experienced no electrolyte or acid-base imbalances, and maintained serum osmolality within normal limits. In contrast to the other solutions, LRA did not induce edema in unburned tissues, and seemed optimal for burn resuscitation.
Carvajal
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HF
Department of Pediatrics, University of Texas Medical School, Houston 77030.
Parks
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DH
D000418:Albumins / Q000627:therapeutic use*; D000818:Animals; D001798:Blood Proteins / Q000032:analysis; D002056:Burns / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy; D006439:Hemodynamics / Q000187:drug effects; D007552:Isotonic Solutions / Q000627:therapeutic use*; D009997:Osmotic Pressure; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D012756:Sheep; D012965:Sodium Chloride / Q000627:therapeutic use*
D000418:Albumins; D001798:Blood Proteins; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic; D012965:Sodium Chloride