The Treatment of Burn Shock: A Comparative Controlled Trial of Treatment by Colloid Infusion (Dextran-Saline), and by Exclusively Electrolyte Infusion (Ringer Lactate)

Abstract

Whether colloid mixtures or exclusively electrolyte solutions should be preferred for treatment of extensively burned patients during the first days is not clear at present. Earlier reports from this department have reviewed the results of treatment with plasma, saline and Dextran, but these regimes were instituted at different times. The present investigation was a randomized simultaneous study comprising every patient admitted to the Burns Unit over a period of one year, the common factor being that all required prophylactic or actual treatment for shock. Forty-three patients are concerned, 21 treated by dextran saline infusion and 22 by Ringer lactate infusion. It is apparent that the random selection was effective. The groups are well matched. Volume of fluid intake over 48 hours after accident, expressed as a percentage of initial body weights, was the same in both groups: the one receiving, largely, colloids (Dextran), while the other received only electrolytes. Thus the latter group received more sodium ions, and, additionally, acid-base active substances, but no colloid. Both fluids preserved renal function. Hourly diuresis was larger in the Ringer group, and sodium excretion virtually normal within the first 24 hours, and within the first 14 days. This excretion was markedly reduced in the Dextran group. Haemoconcentration was much more marked in the Ringer group, but acid-base balance was restored to normal more rapidly than in the Dextran group. Two patients died in the Ringer group and three in the Dextran group. No clinical differentiation could be made between the progress of the patients in the two groups.