[Chloride and lactate composition of hypertonic sodium solution for fluid resuscitation of burn injury]

This study was performed to determine the appropriate anion composition of hypertonic sodium solution for fluid therapy of severely burned patients. Two different solutions with equal sodium concentration (Na 300 mEq/1) were prepared. The first one, low chloride solution (C1 88 mEq/1), was used for ten patients (group I); the second, high chloride solution (C1 244 mEq/1), for other ten patients (group II). Two groups had the same severity of burn injury. The infusion rate was controlled to achieve an adequate urine output (1.0 ml/kg/hour). The observation period was eight hours after injury and water and sodium intake and renal function were measured. Ccr and FENa were identical in two groups. Although both had same urine output, CH2O of group I increased. Water and sodium intake of group I were lower than those of group II. Water diuresis was related with limited chloride intake in group I and this suggested the relation between urine concentration and chloride loading in kidney. conclusively, hypertonic sodium solution with low chloride concentration requires less volume for resuscitation and may be preferred to high chloride solution in the initial therapy of burn injury.