Modern opportunities for the burn shock resuscitation

Abstract

Burn shock is characterized by significant disturbances of central hemodynamic, the presence of microcirculatory disorders due to primary hypovolemia, stress reaction, mass release of inflammatory response mediators, the development of all types of hypoxia, sharp changes in the acid-base state, blood coagulation, dysproteinaemic changes, electrolyte imbalance and quickly leads to the organ dysfunction and multiple organ failure. In this regard, infusion therapy is important in the treatment of burn patients, aimed at blood rheology improving, tissues microcirculation, acidosis correction. Significant homeostatic disturbances during the burn shock acutely determine the infusion solutions choice problem for the hemodynamic disturbance’s correction. The infusion solutions characteristics of for the correction of hemodynamic disturbances during burn shock have been given. Volume deficit recovery for tissue perfusion support and metabolic acidosis correction can be achieved with crystalloid and colloid solutions. Among plasma substitutes, these are low molecular weight hydroxyethyl starch which replaced dextran and native proteins (albumin, plasma). But crystalloids cause swelling. Dextran are not applied now. Albumin transfusion is indicated only for hypoproteinaemia, and plasma for the coagulation factors deficiency. The role of Rheosorbilact in the correction of hypovolemia and metabolic acidosis in patients with burn disease is shown. The presence in clinical practice of domestic polyionic multifunctional solutions of Rheosorbilact gives a positive impetus to the development of new infusion therapy methods.