Resuscitation fluid composition and myocardial performance during burn shock. 1987

S T Conahan, and A Dupre, and M E Giaimo, and C A Fowler, and C S Torres, and H I Miller
Department of Physiology, Louisiana State University Medical Center, New Orleans 70112.

The present study examines the effects of resuscitation fluid composition on myocardial function, myocardial high-energy phosphate content, and survival following third-degree anesthetic burn to 35-40% body surface area in the guinea pig. Treatment regimens used were 1) no resuscitation, 2) isotonic saline, 3) Ringer's lactate and 4) Ringer's acetate. Fluids were administered at the rate of 0.334 ml/kg/hr/% burn for 4 hr following injury, at which time myocardial function was assessed. Nonburned animals served as controls. In isolated working hearts, significant depression of myocardial function was observed in nonresuscitated and saline-resuscitated animals as evidenced by decreased cardiac output, dP/dt, -dP/dt, and stroke work. Lactate resuscitation produced some improvement in these parameters but did not restore them to those of nonburned control animals. In contrast, Ringer's acetate resuscitation resulted in normal cardiac output and contractility. Myocardial ATP content of hearts obtained from the various resuscitation groups did not differ from that of nonburned control hearts, except for hearts from Ringer's lactate group, which were significantly lower in myocardial ATP than those of the other groups. No differences were found in creatine phosphate content. Resuscitation with the different fluid regimens for 48 hr produced significant differences in survival. Fluids were given at the rate of 4 ml/kg/% burn for 24 hr. Half of the fluid was given in the first 8 hr and the rest during the remaining 16 hr. Nonresuscitated and saline-resuscitated animals showed significant mortality by 24 hr, whereas lactate- and acetate-treated animals had survival rates of 100% and 87.5%, respectively. However, by 48 hr, only acetate-treated animals survived. These data indicate that important differences exist in the effectiveness of different resuscitation fluids and that Ringer's lactate, the fluid most often utilized clinically, may not provide optimum benefit. In light of these results, serious consideration should be given to the substitution of acetate for lactate during the resuscitation of burn shock patients.

UI MeSH Term Description Entries
D007552 Isotonic Solutions Solutions having the same osmotic pressure as blood serum, or another solution with which they are compared. (From Grant & Hackh's Chemical Dictionary, 5th ed & Dorland, 28th ed) Solutions, Isotonic
D008297 Male Males
D009200 Myocardial Contraction Contractile activity of the MYOCARDIUM. Heart Contractility,Inotropism, Cardiac,Cardiac Inotropism,Cardiac Inotropisms,Contractilities, Heart,Contractility, Heart,Contraction, Myocardial,Contractions, Myocardial,Heart Contractilities,Inotropisms, Cardiac,Myocardial Contractions
D012151 Resuscitation The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed) Resuscitations
D002056 Burns Injuries to tissues caused by contact with heat, steam, chemicals (BURNS, CHEMICAL), electricity (BURNS, ELECTRIC), or the like. Burn
D005440 Fluid Therapy Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to WATER-ELECTROLYTE BALANCE. Fluids may be administered intravenously, orally, by intermittent gavage, or by HYPODERMOCLYSIS. Oral Rehydration Therapy,Rehydration,Rehydration, Oral,Oral Rehydration,Rehydration Therapy, Oral,Therapy, Fluid,Therapy, Oral Rehydration,Fluid Therapies,Oral Rehydration Therapies,Oral Rehydrations,Rehydration Therapies, Oral,Rehydrations,Rehydrations, Oral,Therapies, Fluid,Therapies, Oral Rehydration
D006168 Guinea Pigs A common name used for the genus Cavia. The most common species is Cavia porcellus which is the domesticated guinea pig used for pets and biomedical research. Cavia,Cavia porcellus,Guinea Pig,Pig, Guinea,Pigs, Guinea
D000077325 Ringer's Lactate A crystalloid solution that contains SODIUM CHLORIDE; SODIUM LACTATE; POTASSIUM CHLORIDE; and CALCIUM CHLORIDE. It is used for FLUID THERAPY. Hartmann's Solution,Hartmanns Solution,Lactated Ringer's Solution,Lactated Ringers Solution,Ringer's, Lactated,Ringers Lactate,Lactate, Ringer's,Lactate, Ringers,Lactated Ringer Solution,Lactated Ringer's,Ringer's Solution, Lactated,Ringers Solution, Lactated
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D012774 Shock, Traumatic Shock produced as a result of trauma. Traumatic Shock

Related Publications

S T Conahan, and A Dupre, and M E Giaimo, and C A Fowler, and C S Torres, and H I Miller
October 2005, Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns,
S T Conahan, and A Dupre, and M E Giaimo, and C A Fowler, and C S Torres, and H I Miller
June 2004, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen,
S T Conahan, and A Dupre, and M E Giaimo, and C A Fowler, and C S Torres, and H I Miller
August 2008, Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns,
S T Conahan, and A Dupre, and M E Giaimo, and C A Fowler, and C S Torres, and H I Miller
October 2008, Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns,
S T Conahan, and A Dupre, and M E Giaimo, and C A Fowler, and C S Torres, and H I Miller
December 1977, The Journal of surgical research,
S T Conahan, and A Dupre, and M E Giaimo, and C A Fowler, and C S Torres, and H I Miller
January 1992, World journal of surgery,
S T Conahan, and A Dupre, and M E Giaimo, and C A Fowler, and C S Torres, and H I Miller
October 1971, The Journal of surgical research,
S T Conahan, and A Dupre, and M E Giaimo, and C A Fowler, and C S Torres, and H I Miller
August 1984, Clinical pharmacology and therapeutics,
S T Conahan, and A Dupre, and M E Giaimo, and C A Fowler, and C S Torres, and H I Miller
May 2020, Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns,
S T Conahan, and A Dupre, and M E Giaimo, and C A Fowler, and C S Torres, and H I Miller
August 2002, Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns,
Copied contents to your clipboard!