[Observation on the fluid resuscitation and the change in blood sodium of severely burned patients in the early stage].

OBJECTIVE

To study the necessary amount of fluid consisting of electrolyte and colloid, the ratio of electrolyte and colloid used, and the change of blood sodium during early resuscitation in severely burned patients.

METHODS

Sixty-seven patients with total burn surface area (TBSA) equal to or over 70% and full-thickness area equal to or over 50%TBSA, hospitalized from March 2004 to March 2009, were resuscitated with fluid. The infusion amount of electrolyte, colloid, and water, and urinary output of patients at post injury hour (PIH) 24, 48, and 72 were analyzed retrospectively. The variation in blood sodium and fluid infusion at different time points was recorded. Data were processed with SPSS 13.0 software.

RESULTS

Among the 67 patients, hyponatremia occurred in 9 cases, hypernatremia occurred in 5 cases, and 53 patients had normal blood sodium level. The urinary output of patients within PIH 72 was above 70 mL/h. K value was calculated through the formula: actual total infusion amount of electrolyte and colloid (mL) = burn area (%TBSA) x body weight (kg) x K. In the first 24 PIH, K value was about 1.7, and the ratio of electrolyte and colloid was 1.4. In the second 24 PIH, K value was about 1.3 with electrolyte and colloid ratio 1.6. K value in the third 24 PIH was about 0.9 with electrolyte and colloid ratio 2.0.

CONCLUSIONS

The actual amount of resuscitation fluid is slightly larger than that calculated from traditional formula during the early stage in severely burned patients. The amount of electrolytes and the proportion of electrolyte and colloid will influence blood sodium level of patients.