Water-electrolyte imbalance disorders are one of the main manifestations of severe burn injury largely determining the course and prognosis of burn disease. Water balance and microcirculation disorders are followed by dyselectrolytemia. Understanding of these disorders and their timely correction are essential for successful treatment of severely burned patients. Objective. To assess severity of water-electrolyte imbalance in acute period of burn disease and to develop an optimal algorithm for correction. Material and methods. We retrospectively analyzed 44 victims with severe burns, whose daily fluid balance was determined. Standard laboratory tests were performed, including analysis of electrolyte composition and acid-base balance. Victims were divided into 2 groups depending on onset of intensive care. Correction of changes included infusion therapy. Infusion volume on the first day was determined by the Parkland formula, on the 2nd and 3rd days according to clinical situation. Composition depended on disturbances in electrolyte balance and acid-base balance. Conclusion. All severely burned patients develop hypovolemia, dyselectrolytemia and metabolic lactic acidosis in acute period of burn injury. Early initiation of infusion therapy with corrective and balanced solutions leads to restoration of water balance, electrolyte and acid-base disturbances on the 3rd day of burn disease. Delayed therapy was accompanied by more severe hypovolemia, electrolyte imbalance, and metabolic lactic acidosis. Recovery of fluid, electrolyte, and acid-base balance was observed on days 5—6 of burn injury. Conclusion. All severely burned patients develop hypovolemia, electrolyte imbalance, and metabolic lactic acidosis in acute phase of burn injury. Early fluid therapy with corrective and balanced solutions leads to restoration of fluid balance, electrolyte, and acid-base imbalances on day 3 of burn injury. This allows for early surgical treatment.
Orlova et al. (Thu,) studied this question.