[The use of composite sodium lactate and sorbitol composition in fluid resuscitation for shock in patients with major burn].
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OBJECTIVE
To investigate the feasibility of the use of sodium lactate and sorbitol (CISS) in the fluid resuscitation for shock in patients with major burns.
METHODS
Fifty - three adult patients with major burns (hospitalized within 6 hours after burns) were randomly divided into A (n = 24, with i.v. infusion of 50 g/L CISS, 2 000 ml per day) and B (n = 29, with i. v. infusion of 50 g/L glucose, 2 000 ml per day) groups. The amount of electrolytes and colloid as the main resuscitation fluids was calculated according to the formula in both groups. Meanwhile, additional electrolytes and insulin were supplemented to the patients in the B group. The result of combating shock, energy supply, and side effects in the two groups were observed. The changes in hepatic and renal function, and the changes in electrolytes were monitored. The amount of fluid supplementation and urinary volume were recorded. The level of blood glucose of each patient was determined at the admission time and 24, 48, and 72 hours after injury.
RESULTS
No obvious difference was found in control of shock and energy supply between A and B group. There was no side effects or damage to hepatic and renal function related to infused fluids in A group. But the patients of the B group required supplementation of exra electrolytes and insulin during the fluid resuscitation period in order to maintain the normal levels of electrolytes and blood glucose, and this was not necessary in group A. The diuretic effect in group A was better than that in group B (average urinary volume in the first two 24 hours: group A: 1.9 +/- 0.6 and 3.3 +/- 0.8 L; group B:1.0 +/- 0.5 and 2.3 +/- 0.8 L).
CONCLUSIONS
The use of CISS during shock stage of the patients with major burns could be beneficial to the replenishment of blood volume, control of shock, promotion of diuresis and subsidence of edema. It could also provide electrolytes and energy, without the influence on the level of blood glucose.
