Burn resuscitation: crystalloid versus colloid versus hypertonic saline hyperoncotic colloid in sheep. 1996

S C Guha, and M P Kinsky, and B Button, and D N Herndon, and L D Traber, and D L Traber, and G C Kramer
Department of Anatomy and Neurosciences, University of Texas Medical Branch Galveston, USA.

OBJECTIVE The present study was undertaken to assess the fluid balance and hemodynamic effects during the first 8 hrs of resuscitation in animals with a large body surface area burn, using lactated Ringer's solution, 6% hetastarch, and hypertonic saline dextran. METHODS A prospective, blinded, controlled, terminal study, using anesthetized animals. The initial baseline period was followed by scald injury, and three different treatment regimens were administered from coded bags to achieve a physiologic end point. METHODS University laboratory. METHODS Eighteen female sheep (35 to 45 kg) were anesthetized with isoflurane. METHODS Test solutions (10 mL/kg of either lactated Ringer's solution, hetastarch, or hypertonic saline dextran) were infused 30 mins after the scald injury at a rate to restore and maintain the baseline oxygen delivery (DO2) value. RESULTS Cardiovascular hemodynamics, plasma sodium concentration, plasma colloid osmotic pressure, and fluid balance were measured before and after scalding and resuscitation. After the initial 10-mL/kg test solution dose was given, lactated Ringer's solution was infused to achieve the same end point of baseline DO2 for the remainder of the 8 hrs. The scald caused an initial 30% reduction in cardiac output, a 20% reduction in mean arterial pressure, and 10% to 15% increase in hematocrit. All three test solutions restored and maintained baseline DO2 within 1 hr. However, hetastarch and hypertonic saline dextran reduced the net fluid volume over 8 hrs by 48% and 74%, respectively, compared with lactated Ringer's solution. Edema in the burn wound was not affected by treatment, while hypertonic saline dextran reduced edema in nonburned skin compared with both lactated Ringer's solution and hypertonic saline dextran. Plasma colloid osmotic pressure was significantly higher in the hetastarch and hypertonic saline dextran groups. A continuous decrease in plasma sodium concentrations from baseline values (140 to 145 mmol/L) was measured in the lactated Ringer's solution and hetastarch groups (130 to 133 mmol/L) over 8 hrs. Plasma sodium concentrations in the group receiving hypertonic saline dextran were increased (150 to 155 mmol/L) at 4 hrs, but returned toward baseline by 8 hrs. CONCLUSIONS Net volume loading can be reduced markedly by initial resuscitation of large body surface area burn injury using a colloid (hetastarch), and can be further reduced by use of hypertonic saline colloid. Hyponatremia was apparent in the isotonic crystalloid- and colloid-treated animals, but not in those animals treated with hypertonic saline colloid.

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
D010100 Oxygen An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration. Dioxygen,Oxygen-16,Oxygen 16
D010952 Plasma Substitutes Any liquid used to replace blood plasma, usually a saline solution, often with serum albumins, dextrans or other preparations. These substances do not enhance the oxygen- carrying capacity of blood, but merely replace the volume. They are also used to treat dehydration. Blood Expanders,Plasma Volume Expanders,Expanders, Blood,Expanders, Plasma Volume,Substitutes, Plasma,Volume Expanders, Plasma
D012079 Renal Circulation The circulation of the BLOOD through the vessels of the KIDNEY. Kidney Circulation,Renal Blood Flow,Circulation, Kidney,Circulation, Renal,Blood Flow, Renal,Flow, Renal Blood
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
D003102 Colloids Two-phase systems in which one is uniformly dispersed in another as particles small enough so they cannot be filtered or will not settle out. The dispersing or continuous phase or medium envelops the particles of the discontinuous phase. All three states of matter can form colloids among each other. Hydrocolloids,Colloid,Hydrocolloid
D005260 Female Females
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006895 Hydroxyethyl Starch Derivatives Starches that have been chemically modified so that a percentage of OH groups are substituted with 2-hydroxyethyl ether groups. Hetastarch,Elohes,HAES-steril,Hemohes,Hespan,Hydroxyethyl Starch (130 KD-0.4 Substitution),Hydroxyethyl Starch 130-0.4,Hydroxyethylated Starches,Pentafraction,Pentaspan,Pentastarch,Plasmasteril,Starches, 2-Hydroxyethyl,2-Hydroxyethyl Starches,Derivatives, Hydroxyethyl Starch,Hydroxyethyl Starch 130 0.4,Starch Derivatives, Hydroxyethyl,Starches, 2 Hydroxyethyl,Starches, Hydroxyethylated

Related Publications

S C Guha, and M P Kinsky, and B Button, and D N Herndon, and L D Traber, and D L Traber, and G C Kramer
September 1979, Surgery,
S C Guha, and M P Kinsky, and B Button, and D N Herndon, and L D Traber, and D L Traber, and G C Kramer
March 2006, Clinics in perinatology,
S C Guha, and M P Kinsky, and B Button, and D N Herndon, and L D Traber, and D L Traber, and G C Kramer
October 1986, Connecticut medicine,
S C Guha, and M P Kinsky, and B Button, and D N Herndon, and L D Traber, and D L Traber, and G C Kramer
January 1996, The American journal of physiology,
S C Guha, and M P Kinsky, and B Button, and D N Herndon, and L D Traber, and D L Traber, and G C Kramer
September 1979, Surgery,
S C Guha, and M P Kinsky, and B Button, and D N Herndon, and L D Traber, and D L Traber, and G C Kramer
November 1984, Surgery, gynecology & obstetrics,
S C Guha, and M P Kinsky, and B Button, and D N Herndon, and L D Traber, and D L Traber, and G C Kramer
October 1976, Journal of pediatric surgery,
S C Guha, and M P Kinsky, and B Button, and D N Herndon, and L D Traber, and D L Traber, and G C Kramer
January 1998, Likars'ka sprava,
S C Guha, and M P Kinsky, and B Button, and D N Herndon, and L D Traber, and D L Traber, and G C Kramer
June 2006, Critical care medicine,
S C Guha, and M P Kinsky, and B Button, and D N Herndon, and L D Traber, and D L Traber, and G C Kramer
November 2001, The Veterinary clinics of North America. Small animal practice,
Copied contents to your clipboard!