Study On Effects Of Oral Hypertonic Electrolyte-glucose Solution In Resuscitation Of 35% TBSA Burn

Objective Burn injury often occurs in mass disaster or war.Because there were a large number of burned-injury patients far away from medical service,it was difficult to treat shock with intravenous injection solution.The survival rate was markedly decreased because of the deficiency of solution resuscitation. Considerable evidences have shown that oral solution was adoptable for resuscitation of burned patients.While it still needs lot amount of oral liquid for resuscitation.On account of above,we hyperthesis that resuscitate with oral hypertonic electrolyte-glucose solution for burn injury should be useful which can save the quantity of liquids.By observing the gastric emptying rate, intestine absorption rate and effects of resuscitation,we aim to seek a convenient and highly performanced resuscitation project for early phase of burn injury.MethodsPart 1:Thirty beagle dogs with 35%TBSA third degree burn were adopted in the study,which were randomized to five groups(n=6):(1)NR group: non-resuscitation;(2)EHEGS group:HEGS was given for resuscitation of burn injury by intestine,volumed 2ml/(kg·1%TBSA).(3)VHEGS group:HEGS was given by intravenous infusion,volumed the same to the EHEGS group.(4) EEGS group:EGS was given for resuscitation of burn injury by intestine, volumed 4ml/(kg·1%TBSA).(5)VEGS group:EGS was given by intravenous infusion,volumed the same to the EEGS group.Hemodynamics parameters were measured by PICCO and PV measured by ICG.Intestinal absorptive rates of water,Na⁺ and glucose were assessed with phenol red.IBF(Intestinal mucosa blood flow),activities of DAO and SOD of plasma and Na⁺-K⁺ ATPase of intestinal mucosa was detected. Part 2:Eighteen beagle dogs with 35%TBSA third degree burn were adopted,which were randomized to three groups:(1)GHEGS group:HEGS was given for resuscitation of burn injury by intergastric administration, volumed 2ml/(kg·1%TBSA).(2)MGHEGS group:HEGS and Mosapride were given by intergastric administration,volumed the same to the GHEGS group.(3)VHEGS group:HEGS was given by intravenous infusion,volumed the same to the GHEGS group.Gastric emptying rates of normal and burn injury dogs were measured by determinated by detecting of the radioactivity of intragastric ^99mTc-DTPA.Hemodynamics parameters,PV,intestinal absorptive rates and IBF were measured.The activities of MTL were also detected.Result1.Hemodynamics status of four resuscitation groups were all improved compared to that of non-resuscatation group(P＜0.01).In four resuscatatoin groups,the dp/dtmax and ITBI of two groups resuscitated with HEGS were higher than that of two groups resuscited with EGS(P＜0.01);SVRI,EVWL and PVPI of two groups resuscitated with HEGS were lower than that of two groups resuscitaed with EGS(P＜0.01).Meanwhile,PV,VO₂,DO₂,IBF,activity of SOD were higher in two groups of HEGS than the other three goups(P＜0.01). The intestinal absorptive rates of water were lower in EHEGS group than in EEGS group(P＜0.05);the absorptive rates of Na⁺ were higher in EHEGS group than EEGS group(P＜0.05).IBF and activity of Na⁺-K⁺ ATPase were higher in EHEGS group and EEGS group than NR group(P＜0.01).The activities of DAO were lower in EHEGS group and EEGS group than NR group(P＜0.01).2.Activity of MTL in plasma and gastric emptying rate were all lowered after burn-injury(P＜0.01),which were raised by administration of Mosapride (P＜0.01).The improvement of hemodynamics status,elevation of PV and IBF in the burn-injury dogs of GHEGS groups was later than that of VHEGS group (P＜0.01).While with Mosapride administatrion,this improvement procedure happend similarly to the EHEGS group(P＞0.05).Conclusion It was feasible for 35%TBSAⅢ°burn-injury dogs to be resuscitated with oral 1.8%hypertonic electrolyte-glucose solution.This solution can markedly reduce liquid quantity,decrease the vasopermeability, strengthen the myocardial contractile force,sublimate the preload,lessen the vascular resistance,and restrain the release of oxygen free radical.The administration of Mosapride can improve gastric emptying after burn injury.