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• W1997896031 abstract "T HE ffuid therapy of extensive full-thickness burns has been a subject for investigation and controversy for the past thirty years. UnderhiII’ emphasized the fluid 10s~; BIaIock2 believed this to be primariIy Ioss of pIasma. On the other hand, Davidson3 described a disturbance in sodium chloride metaboIism. The therapeutic roIe of sodium in burned mice was discovered by RosenthaI in numerous experiments which revealed the critica importance of an adequate volume of administered fluid. These factors were then explored in humans in preliminary clinica triaIs of the use of sodium saIt soIutions by Fox. 5 Whole blood was then combined with eIectroIyte soIutions in burned dogs by Moyer,6 and Abbott? utilized this combination in humans. McCarthy and Parkins@ and hlcCarthy8b in Ravdin’s Iaboratory, investigated aIbumin, saline, dextrose in water and various combinations with blood, pIasma and sodium Iactate in burned rats. Based on observations in humans and dogs, Evans9 proposed a formula combining bIood, pIasma or plasma extender, saline and dextrose in water. In a11 of these investigations the experimenta conditions, species of anima1 utiIized, criteria of efficacy and basis for evaluation have been different. In most instances the investigators have not compared their studies with those of earIier investigators. When the obvious hazard of extrapoIating resuIts of anima1 experimentation to man is added, it becomes apparent that a sotid foundation for prescribing a formuIa for the treatment of fuII-thickness extensive burns in man does not exist. AccordingIy, three years ago we attempted to organize a comparative study of the Buid therapy of burns in patients. After consultation with numerous experts it was decided to Iimit the study to comparison of two treatment scheduIes: the combination of bIood, pIasma or plasma extender, saIine and dextrose in water versus sodium salt soIutions onIy. The period of comparative study was to extend over the first three days from the time of injury; subsequentIy bIood was to be used as IiberaIIy as required in both groups of patients in preparation for skin grafting. Patients were pIaced in each group on the basis of strict alternation. In both groups measurements of bIood and urine composition were made at frequent intervaIs. The exposure method of Iocal treatment was used wherever feasibIe in both groups. Patients were observed most carefuIIy; had those receiving eIectroIyte onIy shown any need for blood and plasma, these were to be utiIized. The number of patients made avaiIabIe for this study was much smaIIer than anticipated; but the program has been continued and with the passage of time a Iarger and proportionateIy more vaIuabIe series of study cases will be achieved. Because of the Iimited number of patients it is essentia1 to recognize the preIiminary nature of this report and to understand that we are unabIe to draw any statisticahy vaIid conclusions at this time. We also conducted a detaiIed survey of approximately 140 patients with extensive burns, of whom 100 died. The combined clinical materia1 raises many important questions which we present for your consideration. It is apparent from our experiences and those of others that extensive fuII-thickness burns of more than 40 per cent of body surface area (BSA) are frequentIy fata1, and unfortunatety many patients with Iess extensive burns" @default.
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• W1997896031 date "1955-04-01" @default.
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• W1997896031 title "Observations on the effects of blood, plasma and sodium salt solutions in the treatment of extensive burns" @default.
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• W1997896031 doi "https://doi.org/10.1016/0002-9610(55)90136-7" @default.
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