Effects on ischemia-reperfusion injury with different fluid resuscitation regimens during burn shock stage in swines

Abstract

To explore the effects on ischemia-reperfusion injury with different regimens of fluid resuscitation during severe burn shock stage in swines. A total of 24 Guangxi BA-MA mini-swine were numbered from 1 to 24 and randomly divided by EXCEL 2007 into 4 groups of succinylated gelatin, hydroxyethyl starch (HES 130/0.4), Parkland and allogeneic plasma (n = 6 each). Then the burn shock model was established. And fluid resuscitation therapy was applied according to the established regimens of burn shock fluid resuscitation. Blood samples were collected from the animals prior to burn injury and again at intervals of 4, 8, 24 and 48 hours post-injury. The levels of malondialdehyde, superoxide dismutase (SOD), xanthine oxidase (XOD) and total antioxidant capacity (T-AOC) were measured. And the results were analyzed statistically. Six swines within each group survived the shock stage and the outliers in detection index were eliminated. Then there were 5 swines in each group. The MDA of allogeneic plasma group at intervals of 8 hours was significantly lower than that of succinylated gelatin group, but higher than that of Parkland group [(3.46 ± 0.40) vs (4.55 ± 0.82), (2.59 ± 0.35) µmol/L, both P < 0.05]. The level of SOD had statistical difference at 48 hours between the HES 130/0.4 and allogeneic plasma groups ((72.55 ± 5.70) vs (65.42 ± 5.07) U/ml, P < 0.05). The level of XOD of the succinylated gelatin group at 4, 8 hour and they increased when compared to pre-burn ((12.00 ± 0.57), (11.28 ± 0.71) vs (9.12 ± 0.51) U/L, both P < 0.01).Statistical significance was observed at 4, 8 hours between succinylated gelatin and allogeneic plasma groups ((10.39 ± 1.24), (9.59 ± 1.17) U/L, both P < 0.01). The T-AOC of HES 130/0.4 group at 8 hours exceed the pre-burn ((2.06 ± 0.43) vs (1.30 ± 0.35) U/ml, P < 0.05). The allogeneic plasma group at 4, 8 hours showed increase when compared to pre-burn ((1.55 ± 0.37), (2.59 ± 0.60) vs (1.06 ± 0.13) U/ml, both P < 0.05). The succinylated gelatin group at 8, 48 hours decreased during the corresponding phase of allogeneic plasma group ((1.14 ± 0.26), (0.89 ± 0.20) vs (2.59 ± 0.60), (1.16 ± 0.20) U/ml, both P < 0.05). The comparison at 24, 48 hours between HES 130/0.4 and allogeneic plasma groups ((1.84 ± 0.41), (1.53 ± 0.21) vs (1.13 ± 0.35), (1.16 ± 0.20) U/ml) had statistical difference (both P < 0.01). The Parkland group at intervals of 8 hours was lower than that of allogeneic plasma group ((1.31 ± 0.19) vs (2.59 ± 0.60) U/ml, P < 0.01). HES130/0.4 and allogeneic plasma have comparable the parallel minimum damage effect on ischemia-reperfusion injury during burn shock stage are.