Usefulness of Warm Fluid in Acute Burn Resuscitation: An Experimental Study in Dogs

Abstract

NAKAZAWA, H. and NOZAKI, M. Usefulness of Warm Fluid in Acute Burn Resuscitation: An Experimental Study in Dogs. Tohoku J. Exp. Med., 2005, 207 (2), [149][150][151][152][153][154][155] Hypothermia is a common complication in patients with extensive burns, receiving massive volumes of fluid for resuscitation at ambient temperature. It is therefore important to maintain the body temperature of patients with extensive burns. The present study was performed to evaluate the usefulness of warm fluid for burn injury resuscitation. Ten dogs were used in this study. Full-thickness burns, involving 40% of the body surface, were generated in the backs of the animals. In the control group (n = 5), the fluid temperature was maintained at about 23°C, while in other group (n = 5), the temperature of the fluid was maintained at 39°C with a warming device. Cardiac output and urinary output were measured in both groups for up to 24 hours. The cardiac output decreased in all animals during the first two hours following injury. The cardiac dynamics remained depressed in the control group. By contrast, in animals treated with warm fluid, the cardiac output returned to the baseline level within 4 hours of resuscitative measures and then decreased slightly for the subsequent 20 hours. The urinary output was better in animals treated with warm fluid, indicating the improved hemodynamic state in these animals. These results suggested that the hemodynamic state in acute burn shock was ameliorated by the use of warm fluid. Therefore, warmed fluid resuscitation might be useful to perform immediate excision and grafting for the patients with extensive burns in acute burn shock. acute burn shock; fluid resuscitation; warming device; hypothermia; hemodynamics © 2005 Tohoku University Medical PressIt is important to maintain the body temperature of patients with extensive burns. For this purpose, it is usual to raise the ambient temperature and to warm the patient using a heating device. Hypothermia is a common complication in patients with extensive burns, receiving massive volumes of fluid for resuscitation at ambient temperature. In addition, coating of the burn wounds with massive amounts of disinfectant and ointment lowers the body temperature of these patients. Under these conditions, patients with extensive burns can suffer hypothermia at ambient temperatures less than 35°C. Hypothermia causes coagulopathy, delays drug metabolism, increases

In vitro evaluation of the efficacy of a veterinary dry heat fluid warmer

“…The administration of unwarmed IV fluids or blood products is a cause of hypothermia that has been associated with adverse outcomes in human studies . Hypothermia secondary to fluid administration can be prevented by the warming of IV solutions . We chose the TEMPCARE as a readily available and affordable example of a veterinary specific in‐line fluid warmer.…”

“…Human studies have demonstrated that prewarmed fluid administration can be effective in minimizing hypothermia . This has been associated with improved postoperative hemodynamic performance, decreased incidence of shivering, and shorter recovery times …”

Severe burn injury, burn shock, and smoke inhalation injury in small animals. Part 2: diagnosis, therapy, complications, and prognosis

“…Hypothermia is a common complication in SBI patients. Cooling of burn wounds, large‐volume fluid resuscitation, low ambient temperatures, topical wound treatments, and prolonged surgical procedures all contribute to hypothermia . Hypothermia can have profound adverse effects on coagulation, drug metabolism, oxygen consumption, and risk of infection .…”

“…Cooling of burn wounds, large‐volume fluid resuscitation, low ambient temperatures, topical wound treatments, and prolonged surgical procedures all contribute to hypothermia . Hypothermia can have profound adverse effects on coagulation, drug metabolism, oxygen consumption, and risk of infection . Attempts to maintain normal body temperature in burn patients include warming the room to 33°C (91.4°F) to decrease evaporative losses, warming inspired air, utilizing warming blankets and countercurrent heat exchangers for infused fluids .…”

“…81,118 Hypothermia can have profound adverse effects on coagulation, drug metabolism, oxygen consumption, and risk of infection. 11,118 Attempts to maintain normal body temperature in burn patients include warming the room to 33 • C (91.4 • F) to decrease evaporative losses, warming inspired air, utilizing warming blankets and countercurrent heat exchangers for infused fluids. 10,80,84 This increase in ambient temperature also augments the hypermetabolic response.…”