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Hypertonic saline resuscitation: efficacy in a community-based burn unit.
J A Griswold1, B L Anglin, R T Love
1Department of Surgery, University of Mississippi Medical Center, School of Medicine, Jackson 39216-4505.
Southern Medical Journal
|June 1, 1991
Summary
Hypertonic saline effectively resuscitated burn patients, reducing fluid needs and avoiding complications like weight gain. This study supports its use as a standard treatment in burn care.
Area of Science:
- Emergency Medicine
- Trauma Surgery
- Critical Care
Background:
- Hypertonic saline (HTS) use in burn resuscitation is debated, often relegated to research.
- Traditional fluid resuscitation methods can lead to significant fluid overload and complications.
Purpose of the Study:
- To evaluate the safety and efficacy of HTS as a standard resuscitation fluid in adult burn patients.
- To compare HTS resuscitation with Parkland formula calculations.
Main Methods:
- Retrospective review of 47 adult burn patients (≥20% TBSA) treated with HTS.
- HTS solution: 300 mEq/L sodium, 200 mEq/L acetate, 100 mEq/L chloride (600 mOsm/L).
- Patients received HTS alone or with colloid (albumin/FFP).
Main Results:
- HTS alone required 75% of calculated Parkland volume; HTS with colloid required 57%.
- Mean hematocrit and serum sodium remained within normal limits.
- No significant changes in pH or renal function; all patients survived resuscitation.
Conclusions:
- HTS is a safe and effective resuscitation fluid for major burns, even in community settings.
- HTS allows for reduced fluid administration and avoids common complications of isotonic fluids.
- Colloid addition may enhance HTS resuscitation effectiveness.