Comparison of ringer lactate with low molecular weight dextran in ringer lactate [Saviosol] in early burn resuscitation: a prospective study of 10 cases

ABSTRACT

This prospective study tests one brand of low molecular weight dextran [LMWD] in ringer lactate [SAVIOSOL] against Ringer Lactate [RL] alone in burn resuscitation. Ten cases of fresh burns, split into two random groups of five cases each were studied over a period of forty-eight hours and their response to the two types of intravenous [I/V] fluid administration was observed. Average age in the RL group [Group-I] was 22.6 years and burn extent 44.6% total body surface area [TBSA]. LMWD group [Group-II] was aged 18.6 years with 41.2% TBSA burns. Sex ratio was similar in both groups. Total I/V fluid received by Group-I was 7.6 L on day one and 5.141 L on day two. Corresponding figures for Group-II were 7.02 L and 5.03 L respectively. Composition of fluids was similar except that Group-II received SAVIOSOL [mean 1.86 L] on day one while Group-I received no colloid. Resuscitation was evaluated by clinical and laboratory observations. Statistically significant differences between groups were noted in one clinical and one laboratory parameter. Pulse rate during the last 12 hours of study [36-48 hours postadmission] at 111/minute in Group-II, as against 121/minute in Group-I, indicated full volume restoration in the former but continued hypovolemia in Group-I. Platelet count lowered much more in Group-II, suggesting platelet disaggregation and improved microcirculation. Parameters that fell short of statistical significance but were nevertheless suggestive of improved performance by LMWD group included 24-hour urine output, Base deficit and Plasma protein values. It is concluded that addition of LMWD to ringer lactate in early resuscitation of acute burns in helpful in correcting hypovolemia and improving urinary output thus reducing chances of renal shutdown