sodium-bicarbonate and Burns

Topics: Acidosis; Burns; Calcium Carbonate; Drug Incompatibility; Fluid Therapy; Humans; Hypertonic Solutions; Ringer's Lactate; Sodium Bicarbonate

The purpose of this study was to determine the fractional recovery rate of labeled CO(2) in the breath of severely burned children. This information is needed to perform tracer studies of substrate oxidation using carbon-labeled fatty acids. Nine children, ages 4-14 yr with massive burns participated in the study. All experiments were performed 7 days post burn after an overnight fast. A primed (60 micromol/kg), constant (2.0 micromol.kg(-1).min(-1)) infusion of [1,2-(13)C]acetate was given during a 4-h basal period and during a 4-h hyperinsulinemic euglycemic clamp. A priming dose (150 micromol/kg) of NaH(13)CO(3) was given at the beginning of the study. Breath samples were collected every 10 min during the last 40 min of each period. Indirect calorimetry was performed during the last 30 min of each period. The isotopic enrichment of (13)CO(2) was determined by isotope ratio-mass spectrometry, and total CO(2) excretion was measured by indirect calorimetry. The fractional recovery of acetate label was 0.89 +/- 0.05 and 0.88 +/- 0.04 during the basal state and clamp, respectively. We conclude that the fractional recovery of labeled acetate in severely burned children is approximately three times the recovery of a nonburned adult and similar to the value in exercising adults. The high recovery rate reflects the rapid turnover of the TCA cycle in burned children relative to the rate of exchange reactions. Minimal correction of expired CO(2) data is needed in this circumstance to quantify fatty acid oxidation using (13)C-labeled fatty acids.

Topics: Acetates; Adolescent; Blood Glucose; Breath Tests; Burns; Carbon Dioxide; Child; Child, Preschool; Citric Acid Cycle; Energy Metabolism; Female; Glucose Clamp Technique; Heart Rate; Humans; Hypoglycemic Agents; Insulin; Male; Radioactive Tracers; Sodium Bicarbonate

The study aimed at assessing the impact of the introduction of a bicarbonated saline solution on total fluid load, weight gain and acid base status during acute burn resuscitation.. Based on a retrospective patient record review.. Burn care centre of a surgical ICU in a tertiary university hospital.. Two groups of adult patients (20/20), with thermal burns of 25% or more body surface area were studied.. Modification of the resuscitation fluid composition from lactated Ringer's solution (LR: Na 132 mmol/l, Cl 112 mmol/l, 263 mosm/l), to bicarbonated 0.9% saline (BS: Na 180 mmol/l, Cl 154 mmol/l, 340 mosm/l). Age, weight, burn size and depth, inhalation injury, fluid intakes over 48 h post-injury, plasma sodium, chloride, creatinine, albumin levels, blood gases and ventilation support were recorded.. The demographic characteristics of the patients (41 +/- 16 years) in the two groups were not different, with severe burns involving 44 +/- 17% body surface area. While the total fluid volumes administered did not differ, BS was associated with lower plasma pH, base excess and bicarbonate levels for 24 h and with hyperchloraemia. Clinical evolution did not differ.. Using bicarbonated saline solution for resuscitation causes a transient hyperchloraemic dilutional acidosis compared with LR, and has no other detectable clinical impact over the first 10 days after severe burn injury.

Topics: Adult; Analysis of Variance; Burns; Chi-Square Distribution; Critical Care; Female; Fluid Therapy; Humans; Hydroxyethyl Starch Derivatives; Isotonic Solutions; Male; Plasma Substitutes; Resuscitation; Retrospective Studies; Ringer's Solution; Saline Solution, Hypertonic; Sodium Bicarbonate; Treatment Outcome

Topics: Bicarbonates; Burns; Child; Humans; Infusion Pumps; Sodium; Sodium Bicarbonate; Wound Infection