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SALINE SOLUTIONS AND DEXTRAN SOLUTIONS IN THE TREATMENT OF BURN SHOCK
Author(s) -
Sørensen Bent
Publication year - 1968
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.1968.tb14737.x
Subject(s) - saline , medicine , dextran , pulmonary edema , anesthesia , dextran 70 , anuria , edema , hemoconcentration , surgery , shock (circulatory) , lung , hematocrit , chemistry , biochemistry
S ummary Two methods of treating burn shock are analyzed. The two principles are as different as we could find. The saline therapy was performed with saline solutions alone, without using colloids, and according to a formula which is based only on the patient's body weight. The dextran therapy, using dextran in saline solution, in a formula which administers considerably less fluid and sodium, is determined only by the extent of the burn. Both treatments can maintain a satisfactory urinary output and prevent anuria. The saline therapy can prevent hemoconcentration in patients with burns up to 40%, dextran in patients with burns up to 50%, but this formula has its ceiling at 50%. Pulmonary complications are difficult to evaluate. In both series practically all patients with signs of lung burns died, but the saline‐treated patients died earlier and, unlike the dextran‐treated patients, they showed typical post‐mortem findings. With both methods, the mortality rate was kept considerably below that reported by Bull and Fisher. In times of peace we recommend treatment with dextran. The patients are more comfortable, the treatment requires less medical surveillance and gives rise to far less edema than does saline therapy. In time of war, or mass disaster, and particularly for hydrogen bomb attacks, saline therapy is the only possible treatment. We have demonstrated that 80% of our patients with burns of less than 40% are able to manage their anti‐shock therapy by drinking, if they get the fluid they want and take the salt in tablet form. The population might receive the following simple instructions: “uring the first 48 hr after the burn has been sustained, you should drink, per 24 hr, fluid corresponding to 15% of your body weight. For each liter of fluid that you drink take 5 gm (1 teaspoonful) salt.“