Effects on vascular permeability with different fluid resuscitation regimens during burn stage in swines

Abstract

To explore the effects of different fluid resuscitation regimens on vascular permeability during burn stage in swines. A total of 24 Guangxi-BAMA miniature swines 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 (lactated Ringer's solution) and allogeneic plasma (n = 6 each). The model of severe burn shock was established. And fluid resuscitation therapy was applied according to the established regimens of burn shock fluid resuscitation. The parameters of heart rate, blood pressure, urine volume, central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP) were recorded. Blood samples were collected prior to burns and at intervals of 4, 8, 24 and 48 h post-burns. The plasma colloidal osmotic pressure was measured. Evens blue was intravenously injected at 30 min before sacrificing. Then lung tissue samples were obtained and pulmonary vascular permeability index (PMPI) was measured. Statistical analyses were performed. All swines survived shock stage. The inter-group comparison revealed no statistical difference in heart rate, blood pressure, urine volume, CVP or PCWP. The plasma colloidal osmotic pressures (mmHg, 1 mmHg = 0.133 kPa) of four groups at each interval were as follows: (1) pre-burn: 25.4 ± 1.0, 25.9 ± 0.9, 25.5 ± 1.1, 25.0 ± 1.0; (2) 4 h: 24.3 ± 1.0, 25.6 ± 0.9, 13.2 ± 0.5, 25.0 ± 1.1; (3) 8 h: 23.3 ± 0.8, 25.2 ± 1.2, 12.7 ± 0.5, 24.0 ± 0.9; (4) 24 h: 22.0 ± 0.8, 23.1 ± 1.0, 12.4 ± 0.4, 23.3 ± 0.8; (5) 48 h: 22.3 ± 0.8, 24.1 ± 0.8, 18.1 ± 0.4, 23.5 ± 0.9. No statistically significant differences existed at the intervals of pre-burn between four groups (all P > 0.05). The HES 130/0.4 group at 8 h was significantly higher than that of allogeneic plasma group at the same interval (P < 0.05). The Parkland group at 4, 8, 24, 48 h were significantly lower than those of allogeneic plasma group (all P < 0.05). The succinylated gelatin group at 8, 24, 48 h, the HES 130/0.4 group at 8, 24, 48 h, the Parkland group at 4, 8, 24, 48 h and allogeneic plasma at 8, 24, 48 h decreased versus those at pre-burns (all P < 0.05). No statistically significant differences existed in pulmonary vascular permeability between the groups of succinylated gelatin (7.6 ± 0.9) µg/g, HES 130/0.4 (7.9 ± 1.8) µg/g, and allogeneic plasma (7.6 ± 1.2) µg/g, but all lower than the Parkland group (26.1 ± 2.3) µg/g (all P < 0.05). Natural colloid or artificial colloid (HES 130/0.4 or succinylated gelatin) have similar effects on vascular permeability in swines with severe burns during shock stage. Both are superior to the Parkland group.