title: Hemodynamic effects of delayed initiation of antioxidant therapy (beginning two hours after burn) in extensive third-degree burns.
abstract: The hemodynamic effects of the delayed initiation of antioxidant therapy with high-dose vitamin C were studied in 12 guinea pigs with third-degree burns over 70% of their body surface area. All animals were resuscitated with Ringer's lactate solution (RL) according to the Parkland formula (4 ml/kg/% burn during the first 24 hours) from 1/2 to 2 hours after burn, and the infusion rate was reduced thereafter to 25% of that of the Parkland formula. The vitamin C group (n = 6) received RL with vitamin C (14 mg/kg/hr), and the control group (n = 6) received RL only. The 24-hour fluid intake for each group was 32.5% of the Parkland formula volume. Burn wound edema in the vitamin C group was significantly less than that in the control group. The vitamin C group maintained adequate hemodynamic stability as determined with hematocrit and cardiac output values, but the control group did not. Even though the initiation of the vitamin C administration is delayed until 2 hours after burn, the hourly infusion rate of the resuscitation fluid can be reduced to 25% once it is started. Thus antioxidant therapy with adjuvant vitamin C administration may be applicable to the clinical setting in which a patient with burns arrives at the burn care facility a few hours after the burn injury occurred.
authors.affiliation: Burn Center, Cook County Hospital, Chicago, IL 60612, USA.
authors.forename: H
authors.initials: H
authors.lastname: Tanaka
authors.forename: M
authors.initials: M
authors.lastname: Hanumadass
authors.forename: H
authors.initials: H
authors.lastname: Matsuda
authors.forename: S
authors.initials: S
authors.lastname: Shimazaki
authors.forename: R J
authors.initials: RJ
authors.lastname: Walter
authors.forename: T
authors.initials: T
authors.lastname: Matsuda
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D002056:Burns / Q000503:physiopathology / Q000628:therapy*; D004195:Disease Models, Animal; D004334:Drug Administration Schedule; D005440:Fluid Therapy; D006168:Guinea Pigs; D006439:Hemodynamics / Q000187:drug effects; D007262:Infusions, Intravenous; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D000975:Antioxidants; D001205:Ascorbic Acid