Xiangxi Meng1, Juan Li, Xiaodong Bai, Sen Hu, Zhiyong Sheng. 1. Laboratory of Shock and Organ Dysfunction, Burns Institute, the First Hospital Affiliated to the People's Liberation Army General Hospital, Beijing 100048, China. Corresponding author: Hu Sen, Email: bs0425@163.com.
Abstract
OBJECTIVE: To compare the effect of intravenous resuscitation with sodium pyruvate (Pyr) Ringer solution against lactated Ringer solution on hemodynamic and organ functions during shock stage in dogs with burn. METHODS: 28 Beagle dogs were subjected to 50% total body surface area (TBSA) burn, and they were divided into three groups: burn injury without fluid resuscitation (NR, n=8), Ringer lactate solution (RL, n=10), and Pyr Ringer solution (RP, n=10). They were given intravenous fluid resuscitation according to Parkland formula 30 minutes after burn. The hemodynamics, organ functions and mortality were observed in conscious state before burn injury, and 2, 6, 8, 12, 24 hours after burn injury. RESULTS: Within 24 hours after burn, all the dogs in NR group died, and those in RL and RP groups were all alive. At 2 hours after burn, the mean arterial pressure (MAP), cardiac index (CI), dp/dt max of left ventricular contractility were significantly reduced in NR, RL and RP groups compared with those before injury (MAP: 45.33±7.78 mmHg vs. 141.67±5.98 mmHg, 91.33±10.25 mmHg vs. 142.33±6.16 mmHg, 98.67±9.54 mmHg vs. 142.83±5.47 mmHg; CI: 8.17±0.83 mL×s(-1)×m(-2) vs. 48.34±3.33 mL×s(-1)×m(-2), 16.84±2.17 mL×s(-1)×m(-2) vs. 47.34±1.67 mL×s(-1)×m(-2), 19.00±1.50 mL×s(-1)×m(-2) vs. 47.34±1.33 mL×s(-1)×m(-2); dp/dt max: 426.83±51.91 mmHg/s vs. 1 372.50±39.61 mmHg/s, 594.00±88.23 mmHg/s vs. 1 363.83±44.92 mmHg/s, 645.00±66.82 mmHg/s vs. 1 395.83±19.49 mmHg/s, all P<0.05), and the systemic vascular resistance (SVR) and alanine transaminase (ALT), creatinine (Cr), serum MB isoenzyme of creatine kinase (CK-MB), diamine oxidase (DAO) were significantly higher (SVR: 1 322.50±36.37 kPa×s×L(-1) vs. 281.45±8.84 kPa×s×L(-1), 777.50±41.84 kPa×s×L(-1) vs. 289.72±6.70 kPa×s×L(-1), 571.40±40.01 kPa×s×L(-1) vs. 286.27±8.66 kPa×s×L(-1); ALT: 89.50±4.11 U/L vs. 40.57±3.63 U/L, 89.25±4.88 U/L vs. 37.92±2.62 U/L, 86.30±5.61 U/L vs. 38.47±3.50 U/L; Cr: 75.62±4.61 μmol/L vs. 41.58±2.78 μmol/L, 77.00±5.92 μmol/L vs. 46.55±3.17 μmol/L, 74.13±2.56 μmol/L vs. 45.65±1.83 μmol/L; CK-MB: 13.122±0.282 kU/L vs. 1.557±0.009 kU/L, 8.885±0.272 kU/L vs. 1.497±0.009 kU/L, 8.692±0.180 kU/L vs. 1.490±0.005 kU/L; DAO: 2.26±0.14 kU/L vs. 0.25±0.02 kU/L, 1.50±0.07 kU/L vs. 0.25±0.01 kU/L, 1.37±0.07 kU/L vs. 0.25±0.02 kU/L, all P<0.05). All parameters in NR group kept on worsening till death, while hemodynamic and organ functions of two intravenous resuscitation groups were gradually improved, CI, SVR and DAO in RP group were significantly superior to those of RL group from 2 hours on after burn (all P<0.05), and dp/dt max and CK-MB in RP group were significantly better than those of RL group from 6 hours on after burn (dp/dt max: 1,082.33±63.59 mmHg/s vs. 1,018.60±47.36 mmHg/s, CK-MB: 7,898.70±255.74 U/L vs. 8,438.70±442.00 U/L, all P<0.05), and MAP was significantly better than that of RL group at 6 hours (124.67±9.39 mmHg vs. 114.33±9.16 mmHg, P<0.05), and Cr was significantly better than that of RL group from 24 hours on after burn (53.42±4.99 μmol/L vs. 60.77±3.11 μmol/L, P<0.05). CONCLUSIONS: The Pyr Ringer solution was superior to the Ringer lactate solution in improving hemodynamic and organ functions for intravenous resuscitation in dogs with 50%TBSA full thickness burn.
OBJECTIVE: To compare the effect of intravenous resuscitation with sodium pyruvate (Pyr) Ringer solution against lactated Ringer solution on hemodynamic and organ functions during shock stage in dogs with burn. METHODS: 28 Beagle dogs were subjected to 50% total body surface area (TBSA) burn, and they were divided into three groups: burn injury without fluid resuscitation (NR, n=8), Ringer lactate solution (RL, n=10), and Pyr Ringer solution (RP, n=10). They were given intravenous fluid resuscitation according to Parkland formula 30 minutes after burn. The hemodynamics, organ functions and mortality were observed in conscious state before burn injury, and 2, 6, 8, 12, 24 hours after burn injury. RESULTS: Within 24 hours after burn, all the dogs in NR group died, and those in RL and RP groups were all alive. At 2 hours after burn, the mean arterial pressure (MAP), cardiac index (CI), dp/dt max of left ventricular contractility were significantly reduced in NR, RL and RP groups compared with those before injury (MAP: 45.33±7.78 mmHg vs. 141.67±5.98 mmHg, 91.33±10.25 mmHg vs. 142.33±6.16 mmHg, 98.67±9.54 mmHg vs. 142.83±5.47 mmHg; CI: 8.17±0.83 mL×s(-1)×m(-2) vs. 48.34±3.33 mL×s(-1)×m(-2), 16.84±2.17 mL×s(-1)×m(-2) vs. 47.34±1.67 mL×s(-1)×m(-2), 19.00±1.50 mL×s(-1)×m(-2) vs. 47.34±1.33 mL×s(-1)×m(-2); dp/dt max: 426.83±51.91 mmHg/s vs. 1 372.50±39.61 mmHg/s, 594.00±88.23 mmHg/s vs. 1 363.83±44.92 mmHg/s, 645.00±66.82 mmHg/s vs. 1 395.83±19.49 mmHg/s, all P<0.05), and the systemic vascular resistance (SVR) and alanine transaminase (ALT), creatinine (Cr), serum MB isoenzyme of creatine kinase (CK-MB), diamine oxidase (DAO) were significantly higher (SVR: 1 322.50±36.37 kPa×s×L(-1) vs. 281.45±8.84 kPa×s×L(-1), 777.50±41.84 kPa×s×L(-1) vs. 289.72±6.70 kPa×s×L(-1), 571.40±40.01 kPa×s×L(-1) vs. 286.27±8.66 kPa×s×L(-1); ALT: 89.50±4.11 U/L vs. 40.57±3.63 U/L, 89.25±4.88 U/L vs. 37.92±2.62 U/L, 86.30±5.61 U/L vs. 38.47±3.50 U/L; Cr: 75.62±4.61 μmol/L vs. 41.58±2.78 μmol/L, 77.00±5.92 μmol/L vs. 46.55±3.17 μmol/L, 74.13±2.56 μmol/L vs. 45.65±1.83 μmol/L; CK-MB: 13.122±0.282 kU/L vs. 1.557±0.009 kU/L, 8.885±0.272 kU/L vs. 1.497±0.009 kU/L, 8.692±0.180 kU/L vs. 1.490±0.005 kU/L; DAO: 2.26±0.14 kU/L vs. 0.25±0.02 kU/L, 1.50±0.07 kU/L vs. 0.25±0.01 kU/L, 1.37±0.07 kU/L vs. 0.25±0.02 kU/L, all P<0.05). All parameters in NR group kept on worsening till death, while hemodynamic and organ functions of two intravenous resuscitation groups were gradually improved, CI, SVR and DAO in RP group were significantly superior to those of RL group from 2 hours on after burn (all P<0.05), and dp/dt max and CK-MB in RP group were significantly better than those of RL group from 6 hours on after burn (dp/dt max: 1,082.33±63.59 mmHg/s vs. 1,018.60±47.36 mmHg/s, CK-MB: 7,898.70±255.74 U/L vs. 8,438.70±442.00 U/L, all P<0.05), and MAP was significantly better than that of RL group at 6 hours (124.67±9.39 mmHg vs. 114.33±9.16 mmHg, P<0.05), and Cr was significantly better than that of RL group from 24 hours on after burn (53.42±4.99 μmol/L vs. 60.77±3.11 μmol/L, P<0.05). CONCLUSIONS: The Pyr Ringer solution was superior to the Ringer lactate solution in improving hemodynamic and organ functions for intravenous resuscitation in dogs with 50%TBSA full thickness burn.