[Study on intestinal absorption rate of glucose electrolyte solution during enteral resuscitation of 35% total body surface area burn injury in dog].
OBJECTIVE
To investigate the intestinal absorption rate of glucose-electrolyte solution (GES) during enteral resuscitation of burn injury in Beagle dogs, and compare the effect of enteral intake with that of intravenous infusion resuscitation.


METHODS
Twelve male Beagle dogs were subjected to a 35% total body surface area (TBSA) full-thickness flame III degree injury. Thirty minutes after burn, each dog was given either enteral resuscitation with a GES (EGES group) or intravenous resuscitation with lactated Ringer's solution (IVLR group), and the amount and speed of replenishment of fluid were in accordance with Parkland formula. In the first 8 hours post burn, intestinal absorption rates of water and Na+ were continuously assessed using phenol red as a nonabsorbable marker for water absorption rate. The plasma volume (PV) was measured by the dye (indocyanine green) dilution technique, and the plasma concentration of Na+, mean arterial pressure (MAP) cardiac output (CO), and urine volume were also determined in the first 8 hours. All above measurement were performed in animals without anesthesia. At the end of 8-hour-period of experiment, the remnant fluids in the intestine were collected to calculate the total volume of fluid absorbed in 8 hours.


RESULTS
The intestinal absorption rates of water and Na+ reduced markedly down to lowest level (21% and 37% of pre-injury level) at 3.5 hours post burn, and then increased slowly. But the mean absorption rate of water was similar to infusing rate according to Parkland formula [(99+/-47) mlxh(-1)xm(-1) vs. (81+/-11) mlxh(-1)xm(-1), P>0.05]. The total fluid absorbed by intestine was (94.8+/-3.7)% of the total fluid infused within 8 hours post burn. There were no significant differences in plasma concentration of Na+, MAP and CO between two groups at 8 hours post burn. The urine volume and PV at 4 hours in EGES group were lower than those in IVLR group (both P<0.05), but those indexes at 8 hours showed no significant difference between two groups (both P>0.05).


CONCLUSIONS
Intestinal absorption rate of fluid given according to Parkland formula after burn injury is sufficient to resuscitate shock in animals suffering from a 35%TBSA full-thickness burn. Enteral resuscitation with GES may attain a similar therapeutic effect in expanding PV and maintain hemodynamic parameters.
Che
Jin-wei
JW
Laboratory of Shock and Organ Dysfunction, Burns Institute, First Affiliated Hospital of PLA General Hospital, Beijing 100037, China.
Hu
Sen
S
Du
Ying
Y
Bao
Cheng-mei
CM
Tian
Yi-jun
YJ
Wang
Lei
L
Sheng
Zhi-yong
ZY
D000818:Animals; D001830:Body Surface Area; D002056:Burns / Q000628:therapy*; D004195:Disease Models, Animal; D004285:Dogs; D004573:Electrolytes / Q000493:pharmacokinetics* / Q000627:therapeutic use; D005440:Fluid Therapy / Q000379:methods; D005947:Glucose / Q000493:pharmacokinetics* / Q000627:therapeutic use; D007262:Infusions, Intravenous; D007408:Intestinal Absorption / Q000502:physiology*; D007421:Intestine, Small / Q000378:metabolism; D007552:Isotonic Solutions / Q000627:therapeutic use; D008297:Male; D012151:Resuscitation / Q000379:methods*; D000077325:Ringer's Lactate
D004573:Electrolytes; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D005947:Glucose