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Progressive fluid removal can avoid electrolyte disorders in severely burned patients.

ABSTRACT: INTRODUCTION: Extensive burn injury has systemic consequences due to capillary leak. After restoration of cellular integrity, infused fluid volume has to be removed partially. This can provoke electrolyte disorders. PURPOSE: We investigated the effect of progressive fluid removal on serum sodium level. METHOD: Retrospective study. Patients admitted to a burn unit were analyzed and separated in two groups without (Group A) or with (Group B) prolonged hypernatremia. Daily infusion-diuresis-ratio (IDR) was analyzed. RESULTS: Fourty (12 female; 28 male) patients with a mean age of 47±19 years, a total burn surface area (TBSA) of 26±12%, and a mean abbreviated burned severity index (ABSI) score of 7.3±2 were included. In Group A 25 patients with a mean age of 47±18 years, a mean TBSA of 23±11%, and a mean ABSI score of 6.9±2.1 were summarized. In Group B 15 patients with a mean age of 47±22 years, a mean TBSA of 30±13%, and a mean ABSI score of 8.1±1.7 were included. Hypernatremia occurred on day 5±1.4. There was no significant difference between both groups for fluid resuscitation amount within the first 24 hours. Statistical analysis of the first 7 days after burn injury showed a significantly higher percentage of removed fluid in Group B for day 3, day 4, day 5, day 6 and day 7. CONCLUSIONS: Amount and velocity of fluid removal regimen after burn injury can provoke electrolyte disorders. Serum sodium concentration can be used to calculate need of fluid resuscitation for fluid maintenance. There is a need of an established fluid removal strategy.

SUBMITTER: Namdar T

PROVIDER: S-EPMC3118691 | biostudies-other | 2011

REPOSITORIES: biostudies-other

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Progressive fluid removal can avoid electrolyte disorders in severely burned patients.

Namdar Thomas T Stollwerck Peter Leonard PL Stang Felix Hagen FH Kolios Georgios G Lange Thomas T Mailänder Peter P Siemers Frank F

German medical science : GMS e-journal 20110608

<h4>Introduction</h4>Extensive burn injury has systemic consequences due to capillary leak. After restoration of cellular integrity, infused fluid volume has to be removed partially. This can provoke electrolyte disorders.<h4>Purpose</h4>We investigated the effect of progressive fluid removal on serum sodium level.<h4>Method</h4>Retrospective study. Patients admitted to a burn unit were analyzed and separated in two groups without (Group A) or with (Group B) prolonged hypernatremia. Daily infusi ...[more]

PMID: 21698085

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Project description:Low-osmolality carbohydrate-electrolyte solution (LCS) ingestion can replace losses from exercise-induced dehydration, but the benefits of LCS ingestion strategy after exhaustive endurance exercise (EEE) remain unknown. The present study evaluated the effects of LCS ingestion on dehydration, oxidative stress, renal function, and aerobic capacity after EEE. In our study with its double-blind, crossover, counterbalanced design, 12 healthy male participants were asked to consume LCS (150 mL four times per hour) or placebo (water) 1 h before and 1 h after EEE. All participants completed a graded exercise test to exhaustion on a treadmill for the determination of maximal oxygen consumption (VO2max), applied to further intensity calibration, and then completed the EEE test. The average heart rate, maximal heart rate, running time to exhaustion, and peak oxygen uptake (VO2peak) were recorded during the exercise period. The participants' body weight was recorded at different time points before and after the EEE to calculate the dehydration rate. Blood samples were drawn at baseline and before, immediately after, 1 h after, and 2 h after EEE to determine indicators of oxidative stress and renal function. The results indicated that the dehydration rates in participants with LCS ingestion at 15 min, 30 min, and 45 min after EEE were significantly lower than in participants with placebo ingestion (-1.86 ± 0.47% vs. -2.24 ± 0.72%; -1.78 ± 0.50% vs. -2.13 ± 0.74%; -1.54 ± 0.51% vs. -1.94 ± 0.72%, respectively; p < 0.05). In addition, the concentration of catalase in participants with LCS ingestion immediately after EEE was significantly higher than in participants with placebo ingestion (2046.21 ± 381.98 nmol/min/mL vs. 1820.37 ± 417.35 nmol/min/mL; p < 0.05). Moreover, the concentration of protein carbonyl in participants with LCS ingestion immediately after EEE was slightly lower than in participants with placebo ingestion (2.72 ± 0.31 nmol carbonyl/mg protein vs. 2.89 ± 0.43 nmol carbonyl/mg protein; p = 0.06). No differences were noted for other variables. Our findings conclude that LCS ingestion can effectively avoid fluid loss and oxidative stress after EEE. However, LCS ingestion had no benefits for renal function or aerobic capacity.

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Progressive fluid removal can avoid electrolyte disorders in severely burned patients.

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Progressive fluid removal can avoid electrolyte disorders in severely burned patients.

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