| ObjectiveTo clarify the effects of oral fluid replacement on severe burn shock.Material and method1. Therapeutic effects of oral fluid replacement on severe burn shock in rabbitsA total of 150 rabbits were randomly divided into normal control group (group N,n=6),burn group (group S,n=42, subjected to 40% total body surface areaⅢburn injury),immediate oral fluid replacement group (group A,n=42,started to be treated immediatly after burn injury),delayed rapid oral fluid replacement group(group B,n=30,started to be treated at 6h postburn) and delayed oral rehydration group (group C,n=30,started to be treated at 6h postburn).The myocardial mechanic parameters (LVSP,LVEDP,LV±dp/dt max),AOSP,AODP,the level of Cr,Bun,urine output,Hct and LA in serum the N,S groups were investegated at 2,6,8,12,24,36 and 48h post burn and the B and C group were investigated at 8,12,24,36 and 48h post burn.2. Therapeutic effects of oral fluid replacement on severe burn shock under simulated toss condition in rabbitsA total of 150 rabbits were randomly divided into normal control group (group DN,n=6),burn group (group DS,n=42, just subjected to 40% total body surface areaⅢburn injury),immediate oral fluid replacement group (group DA,n=42,started to be treated immediatly after burn injury),delayed rapid oral fluid replacement group(group DB,n=30,started to be treated at 6h postburn ) and delayed oral fluid replacement group (group DC,n=30,started to be treated at 6h postburn).Every group was under simulated toss condition after burn injury. The myocardial mechanic parameters (LVSP,LVEDP,LV±dp/dt max),AOSP,AODP,the level of Cr,Bun,urine output,Hct and LA in serum of the DN,DS groups were investegated at 2,6,8,12,24,36 and 48h post burn and the DB and DC group were investigated at 8,12,24,36 and 48h post burn.3. Therapeutic effects of oral fluid replacement on severe burn shock under sea condition in rabbitsA total of 102 rabbits were randomly divided into normal control group (group HN,n=6),burn group (group HS,n=42, just subjected to 40% total body surface areaⅢburn injury),immediate oral fluid replacement group (group HA,n=42,started to be treated immediatly after burn injury),delayed rapid oral fluid replacement group(group HB,n=30,started to be treated at 6h postburn ) and delayed uniformity oral fluid replacement group (group HC,n=30,started to be treated at 6h postburn).Every group was under toss condition after burn injury. The myocardial mechanic parameters (LVSP,LVEDP,LV±dp/dt max),AOSP,AODP,the level of Cr,Bun,urine output,Hct and LA in serum of every group was investegated at 8,12,24 and 48h post burn.Results1. Therapeutic effects of oral fluid replacement on severe burn shock The levels of myocardial mechanic parameters,AOSP,AODP and urine output were decreased singnificantly and the levels of Cr,Bun, Hct and LA were increased singnificantly after burn injury. The parameters began to be retrieved during 6-8 hours after burn injury with oral fluid replacement.But the oral fluid replacement presented chronergy accord to our reaserch. It was most effective during 6-12 hours after burn injury with oral fluid replacement and the effect began to be unapparent at 24 hours after burn injury.When the resuscitation was delayed,the improvement of group B(delayed rapid oral fluid replacement group) in the parameters was more obvious than group C(delayed oral fluid replacement group).2. Therapeutic effects of oral fluid replacement on severe burn shock under simulated toss conditionThe levels of myocardial mechanic parameters,AOSP,AODP and urine output were decreased singnificantly and the levels of Cr,Bun, Hct and LA were increased singnificantly under simulated condition after burn injury. The parameters was improved with oral fluid replacement.But the parameters of all the groups with oral fluid replacement were abnormal because of the toss. the oral fluid replacement presented chronergy,which was similar to the situation without toss. The effects of oral fluid replacement began to be unapparent at 24 hours after burn injury.When the resuscitation was delayed,the improvement in the parameters of group DB(delayed rapid oral fluid replacement group)with more fluid administrion was more obvious than group DC(delayed oral fluid replacement group).3. Therapeutic effects of oral fluid replacement on severe burn injury under sea conditionThe levels of myocardial mechanic parameters,AOSP,AODP and urine output were decreased singnificantly and the levels of Cr,Bun, Hct and LA were increased singnificantly under simulated condition after burn injury. The parameters was improved with oral fluid replacement.But the parameters of all the groups with oral fluid replacement were abnormal because of under sea condition, which was similar to the situation under simulated toss condition. the oral fluid replacement presented chronergy. The effects of oral fluid replacement began to be unapparent at 24 hours after burn injury.If the resuscitation was delayed,the improvement in the parameters of group HB(delayed rapid oral fluid replacement group)with more fluid administrion was more obvious than group HC(delayed oral fluid replacement group).Discussion and conclusion1. Oral fluid replacement is efficient at resuscitation of burn shock,when the body posture was steady. It can retrieve the levels of myocardial mechanic parameters, AOSP,AODP, urine output, Cr,Bun, Hct and LA during the first 24 hours post burn. Oral fluid replacement can palliate shock under simulated toss or toss on sea condition.However,it seems more effective when the body posture was steady than under toss condition.2. Effects of oral fluid replacement presented chronergy according to our reaserch. The effect of oral rehydration began to be unapparent at 24 hours after burn injury under toss condition. Therefore,oral fluid replacement should be applied during the earlier period post burn in the case that intravenous therapy was unable to be carried out and intravenous therapy should be applied once it was available.3. If the resuscitation was delayed,the volume of oral fluid replacement should be calculatded according to the forluma for the delayed rapid fluid resuscition in burn patients.
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