title: Impact of a bicarbonated saline solution on early resuscitation after major burns.
abstract: 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.
authors.affiliation: Soins Intensifs de Chirurgie, CHUV, Lausanne, Switzerland. Mette.Berger@chuv.hospvd.ch
authors.forename: M M
authors.initials: MM
authors.lastname: Berger
authors.forename: A
authors.initials: A
authors.lastname: Pictet
authors.forename: J P
authors.initials: JP
authors.lastname: Revelly
authors.forename: P
authors.initials: P
authors.lastname: Frascarolo
authors.forename: R L
authors.initials: RL
authors.lastname: Chioléro
mesh_terms: 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
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D012462:Saline Solution, Hypertonic; D000077331:Ringer's Solution; D017693:Sodium Bicarbonate