Impact of a bicarbonated saline solution on early resuscitation after major burns.
OBJECTIVE
The study aimed at assessing the impact of the introduction of a bicarbonated saline solution on total fluid load, weight gain and acid base status during acute burn resuscitation.


METHODS
Based on a retrospective patient record review.


METHODS
Burn care centre of a surgical ICU in a tertiary university hospital.


METHODS
Two groups of adult patients (20/20), with thermal burns of 25% or more body surface area were studied.


METHODS
Modification of the resuscitation fluid composition from lactated Ringer's solution (LR: Na 132 mmol/l, Cl 112 mmol/l, 263 mosm/l), to bicarbonated 0.9% saline (BS: Na 180 mmol/l, Cl 154 mmol/l, 340 mosm/l)


METHODS
Age, weight, burn size and depth, inhalation injury, fluid intakes over 48 h post-injury, plasma sodium, chloride, creatinine, albumin levels, blood gases and ventilation support were recorded.


RESULTS
The demographic characteristics of the patients (41 +/- 16 years) in the two groups were not different, with severe burns involving 44 +/- 17% body surface area. While the total fluid volumes administered did not differ, BS was associated with lower plasma pH, base excess and bicarbonate levels for 24 h and with hyperchloraemia. Clinical evolution did not differ.


CONCLUSIONS
Using bicarbonated saline solution for resuscitation causes a transient hyperchloraemic dilutional acidosis compared with LR, and has no other detectable clinical impact over the first 10 days after severe burn injury.
Berger
M M
MM
Soins Intensifs de Chirurgie, CHUV, Lausanne, Switzerland. Mette.Berger@chuv.hospvd.ch
Pictet
A
A
Revelly
J P
JP
Frascarolo
P
P
Chioléro
R L
RL
D000328:Adult; D000704:Analysis of Variance; D002056:Burns / Q000628:therapy*; D016009:Chi-Square Distribution; D003422:Critical Care / Q000379:methods; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use; D007552:Isotonic Solutions / Q000627:therapeutic use*; D008297:Male; D010952:Plasma Substitutes / Q000627:therapeutic use; D012151:Resuscitation / Q000379:methods*; D012189:Retrospective Studies; D000077331:Ringer's Solution; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D017693:Sodium Bicarbonate / Q000627:therapeutic use*; D016896:Treatment Outcome
D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D012462:Saline Solution, Hypertonic; D000077331:Ringer's Solution; D017693:Sodium Bicarbonate