Effect of intravenously administered fluid on hemodynamic change and respiratory function in extensive thermal injury

In 53 extensively burned patients, a comparative study was conducted on lactated Ringer's solution, colloid plus lactated Ringer's solution and hypertonic lactated saline solution on their hemodynamic and respiratory effects. The total amount of infusion required to resucitate the initial hypovolemic phase was the least in the hypertonic lactated saline solution group; whereas, the total sodium intake was the greatest in the lactated Ringer's solution group. Elevation of the respiratory index in the hypertonic lactated saline solution group was slightly more than the normal range, but insignificant. Cardiac output decreased initially in all three groups, but a hyperdynamic state with a simultaneous increase in the respiratory index occurred rapidly in the lactated Ringer's solution group; however, it occurred after five to seven days in the other two groups. Arteriovenous oxygen content difference increased in the hypertonic lactated saline solution group and decreased in the colloid plus lactaed Ringer's solution group, with no significant change in the lactated Ringer's solution group. From this study, the use of hypetonic lactated saline solution seems to be the best choice in the initial resuscitation of thermal injury.