Comparison of hypertonic vs isotonic fluids during resuscitation of severely burned patients.
BACKGROUND
The hypertonic lactate saline (HLS) solutions with mild concentration of sodium have been used in some burn centers to maintain plasma volume without infusing larger fluids volumes. To evaluate the fluid requirements during resuscitation with lactated Ringer's solution and to realize resuscitation with HLS, we suggest the following clinical trial. Specific objectives include fluid loads, sodium loads, and fluid accumulation.


METHODS
This prospective study included 110 patients with severe burns. The first group included patients resuscitated in the beginning with lactated Ringer's solution, according to Parkland formula for adults and Shriner formula for children. In the other group, the patients were resuscitated with HLS solution. Patients are divided in 2 groups for comparison.


RESULTS
There is difference between sodium loads (P = .03), fluid load in the first hour (P = .001), sodium load in the first hour (P = .001), and net fluid accumulation (P = .0025). There is a difference regarding plasma sodium and plasma osmolality in the first hour (P = .003, P = .002). There is difference regarding sodium given (P = .001) and sodium excreted (P = .001) in 2 groups.


CONCLUSIONS
Hypertonic resuscitation consists in giving a higher fluid and sodium load in the first hour of therapy that is accompanied with a decrease in fluid requirements and fluid accumulation for the first 24 hours of burn shock.
Belba
Monika Kristaq
MK
Service of Anesthesiology, Department of Surgery, Service of Burns and Plastic Surgery, University Hospital Center Mother Teresa, Tirana 1000, Albania. piet_amy@yahoo.com
Petrela
Elizana Ylber
EY
Belba
Gjergji Petro
GP
D000293:Adolescent; D000328:Adult; D000368:Aged; D002056:Burns / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D002648:Child; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007552:Isotonic Solutions / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D012462:Saline Solution, Hypertonic