Small-volume resuscitation using hypertonic saline improves organ perfusion in burned rats

Area of Science:

• Physiology
• Trauma Medicine
• Resuscitation Science

Background:

• Hypertonic saline (HTS) is effective for hemorrhagic shock resuscitation.
• The efficacy of HTS for initial burn injury resuscitation remains unclear.
• Burn injuries cause significant hemodynamic alterations and organ hypoperfusion.

Purpose of the Study:

• To compare the hemodynamic effects of HTS versus lactated Ringer's solution (LR) in burn resuscitation.
• To examine organ tissue perfusion following burn injury and resuscitation with HTS or LR.
• To evaluate HTS as a potential resuscitation fluid for burn shock.

Main Methods:

• Full thickness scald burn (35% TBSA) induced in anesthetized rats.
• Regional blood flows measured using radioactive microspheres pre- and post-burn and resuscitation.
• Comparison between HTS (4 mL/kg), LR (volume-adjusted), and nonresuscitated groups.

Main Results:

• HTS and LR transiently restored mean arterial pressure post-burn.
• HTS resuscitation was associated with tachycardia, unlike LR.
• HTS significantly increased blood flow to the brain, kidney, heart, liver, and testis compared to LR.
• Intestinal perfusion was transiently increased by both fluid resuscitation methods.
• Splenic perfusion improved with both HTS and LR initially, but LR group showed no difference from nonresuscitated at 30 min.

Conclusions:

• HTS resuscitation rapidly improved organ tissue perfusion in burn-injured rats.
• HTS demonstrated superior increases in blood flow to critical organs (heart, kidney, liver, testis) compared to LR.
• HTS may be an effective initial treatment for burn shock, requiring significantly less volume than LR.