Objective: The study aimed at assessing the impact of the introduction of a
bicarbonated saline solution on total fluid load, weight gain and acid bas
e status during acute burn resuscitation.
Design: Based on a retrospective patient record review.
Setting: Burn care centre of a surgical ICU in a tertiary university hospit
al.
Patients: Two groups of adult patients (20/20), with thermal burns of 25% o
r more body surface area were studied.
Intervention: Modification of the resuscitation fluid composition from lact
ated Ringer's solution (LR: Na 132 mmol/l, C1 112 mmol/l, 263 mosm/l), to b
icarbonated 0.9 % saline (BS: Na 180 mmol/l, C1 154 mmol/l, 340 mosm/l)
Methods: 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.
Results: 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 di
ffer BS was associated with lower plasma pH, base excess and bicarbonate le
vels for 24 h and with hyperchloraemia. Clinical evolution did not differ.
Conclusions: 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 i
njury.