52例严重烧伤休克期血流动力学变化监测

目的观察休克期血流动力学监测对复苏的指导意义。方法采用血流动力学监测仪,对我科1985～1996年烧伤总面积在(69.9±20.1)%,Ⅲ度面积(60.4±13.6)%,且人院后均置入 Swan-Ganz 飘浮导管的52例烧伤病人的右房压(RAP)、肺动脉压(PAP)、肺动脉楔嵌压(PAWP)、心率(HR)、心排量(CO)、心排指数(CI)、每搏指数(SI),于入院时及伤后8,16,24,48,72,96h 进行了动态监测。结果休克期实施有创血流动力学监测是安全的,无一例发生并发症;休克病人在烧伤后24h 各项血流动力学指标基本恢复了正常。结论烧伤休克期实施有创血流动力学监测对指导复苏具有重要意义。     

高张氯化钠右旋糖酐液在犬烧伤休克延迟复苏中的作用

目的从血流动力学、心肌力学及代谢等方面探讨高张氯化钠右旋糖酐液（７．５％氯化钠＋６％右旋糖酐７０，ＨＳＤ）在烧伤休克延迟复苏中的作用。方法采用犬３５％ＴＢＳＡⅢ度烧伤模型，伤后６ｈ分别用乳酸林格液及ＨＳＤ进行复苏，并以每ｈ尿量为１０ｍｌ／ｋｇ及心输出量为伤前值的７０％～８０％来调整输液速度及输液量，观察ＨＳＤ在复苏中容量负荷、左心室等容收缩期最大压力变化速率及左心室舒张期压力下降最大变化速率（±ｄｐ／ｄｔｍａｘ）、心脏指数（ＣＩ）、氧供给（ＤＯ２）及氧消耗（ＶＯ２）等的变化。结果ＨＳＤ在烧伤休克延迟复苏伤后第一个２４ｈ输液量比乳酸林格液复苏少３０５６％，其中复苏后４ｈ的输液量比乳酸林格液少５９５０％，在复苏后０５～２ｈ，＋ｄｐ／ｄｔｍａｘ、ＣＩ、ＤＯ２及ＶＯ２的增加幅度明显高于乳酸林格液复苏。结论ＨＳＤ在烧伤休克延迟复苏中具有容量负荷小、改善心肌功能及促进组织代谢等作用。     

严重烧伤抗休克时胃肠粘膜内缺血的研究

目的探讨烧伤早期胃肠缺血（ｐＨｉ降低）的发生规律。方法采用模拟临床的ＴＢＳＡ３０％Ⅲ度烧伤小型猪模型，从血流动力学、胃肠缺血、血液流变学等方面探讨烧伤早期胃肠缺血的发生规律及相关因素。伤后１小时开始复苏，按Ｐａｒｋｌａｎｄ公式补充平衡液。结果烧伤后平均动脉压（ＭＡＰ）无明显变化，但右房压（ＲＡＰ）、平均肺动脉压（ＭＰＡＰ）、肺动脉楔压（ＰＡＷＰ）及心排指数（ＣＩ）等均显著下降，于伤后４８小时降至谷值，经复苏后于２４小时恢复正常。胃肠ｐＨｉ于伤后１小时就迅速下降，并且恢复缓慢，伤后７２小时仍未达到正常。门脉血流量也呈类似变化，并且与肠ｐＨｉ呈显著正相关。门脉全血粘度及血浆粘度均在伤后有明显的提高。结论①胃肠缺血发生早、恢复慢。②与血流动力学变化不一致。③常规液体复苏疗法不易纠正。④门脉血液流变学变化可能加重胃肠缺血损伤     

猪无肝期静脉-静脉被动转流的血流动力学变化

目的与方法：对８只平均体重２５±１２９ｋｇ的幼猪原位肝移植时行无肝期静脉静脉被动转流,观察其对血流动力学的影响。结果：与无肝前期比较,无肝期的肺小动脉嵌压（ＰＡＷＰ）、体循环血管阻力指数（ＳＶＲＩ）和下腔静脉压（ＩＶＰ）明显升高,心脏指数（ＣＩ）、每搏指数（ＳＶＩ）、左室每搏功指数（ＬＶＳＷＩ）和右室每搏功指数（ＲＶＳＷＩ）下降极显著,平均动脉压（ＭＡＰ）有一定程度下降,而中心静脉压（ＣＶＰ）、肺动脉压（ＰＡ）只有轻微变化。结论：静脉静脉被动转流在无肝期对减轻门脉系统瘀血,改善肠管血液循环,防止肠道菌群移位等方面有一定作用。     

犬低血容量休克时血流动力学变化的研究

为探讨失血性休克时血流动力学的变化，用１４只犬进行了研究。实验发现随失血量的增加，犬中心静脉压（ＣＶＰ）、肺毛细血管嵌压（ＰＣＷＰ）、平均动脉压（ＭＡＰ）、平均肺动脉压（ＭＰＡＰ）、每搏量（ＳＶ）、心排血量（ＣＯ））均逐渐降低，周围血管阻力（ＳＶＲ）、肺血管阻力（ＰＶＲ）则逐渐升高。ＳＶ、ＣＯ对失血后反应最为敏感，且能反映失血性休克的严重程度。提示临床在大型手术，估计术中失血较多或需对失血性休克情况作出判断时，全面的血流动力学监测是必要的。     

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目的 评估创伤后失血性休克重症病人的复苏指标。方法 前瞻法临床研究１９９５年１月至１９９９年１月期间,进入上科重症加强医疗病区（ＳＩＵＣＵ）的连续４１例创伤后失血性低血容量休克病人,对所有病例常规采用止血、扩充血容量、儿茶酚胺类药物、稳定内环境等复苏措施,测定初始、１２、２４、４８、７２ｈ血流动力学、氧动力学、血乳酸变化以及２４ｈ内ＡＰＡＣＨＥⅡ评分,比较存活组与死亡组资料。结果 （１）存活组３４     

心脏双瓣置换术麻醉期间血流动力学变化

采用Ｓｗａｎ－Ｇａｎｚ导管及热稀释原理测定心排血量方法，对４９例择期行二尖瓣及主动脉瓣双瓣置换术麻醉期间的血流动力学进行了测定。结果表明：麻醉前心脏指数（ＣＩ）、左心功指数（ＬＶＷＩ）属正常范围，但平均肺动脉压（ＭＰＡＰ）、肺毛细血管嵌压（ＰＣＷＰ）、肺总阻力指数（ＰＴＲＩ）、右心功指数（ＲＶＷＩ）明显异常。诱导后右心前负荷（ＲＡＰ）升高，右心后负荷（ＭＰＡＰ、ＰＣＷＰ）、平均动脉压（ＭＡＰ）、（ＣＩ及左、右心作功降低，显示有心功能可能受抑；气管插管及锯胸骨后血流动力学各项指标均不同程度地回升并超过诱导前，提示心血管功能仍保持对应激的反应能力；主动脉及腔静脉插管时ＣＩ、ＭＡＰ、ＭＰＡＰ、ＰＣＷＰ、ＬＶＷＩ及ＲＶＷＩ均显著降低，显然与此期间近心性、出血及搬动、挤压心脏、严重心律失常等干扰左、右心前后负荷的平衡有关；体外循环后，由于手术纠正了瓣膜病变所致的血流障碍，ＭＰＡＰ、ＰＣＰＰ、ＰＴＲＩ、及 ＲＶＷＩ显著持续下降，而反映肺血管阻力的ＰＶＲＩ无变化；心肺转流（ＣＰＢ）结束后ＭＡＰ、ＳＶＲＩ明显减低，心脏功能也受损，提示此期间应尽早应用心血管活性药并提高患者的血细胞比容。     

肾移植围术期血流动力学的变化

目的和方法：４０例肾移植病人在硬膜外麻醉胶放置Ｓｗａｎ－Ｇａｎｚ导管行围术期血流动力学分析。结果：硬膜外阻滞３０分钟,ＭＡＰ、ＣＶＰ、体循环阻力（ＳＶＲ）下降明显（Ｐ〈０．０５）,而其他指标无明显变化。髂内动脉阻断后,ＭＡＰ、ＣＶＰ逐渐恢复麻醉前水平,而肺循环阻力（ＰＶＲ）则明显升高（Ｐ〈０．０５）。提供肾血流２０分钟内血流动力学变化较大。心输出量（ＣＯ）、心脏指数（ＣＩ）显著增加（Ｐ〈０．０１）     

二尖瓣置换术保留与不保留瓣下结构对术后早期血流动力学的影响

目的比较常规二尖瓣置换术（ＭＶＲ）与保留瓣下结构的二尖瓣置换术（ＭＶＲＰ）对术后早期血流动力学的影响。方法根据术中是否保留瓣下结构分为３组。Ⅰ组：常规ＭＶＲ，切除全部二尖瓣瓣叶及其瓣下结构；Ⅱ组：保留后瓣及其瓣下组织；Ⅲ组：全部保留二尖瓣装置。术后４小时、２４小时和４８小时分别采用Ｓｗａｎ－Ｇａｎｚ导管测定血流动力学指标：平均肺动脉压（ＭＰＡＰ）、肺毛细血管嵌压（ＰＣＷＰ）、肺血管阻力（ＰＶＲ）、外周血管阻力（ＳＶＲ）、心脏指数（ＣＩ）和左心室每搏作功指数（ＬＶＳＷＩ）。结果术后Ⅰ组ＭＰＡＰ，ＰＶＲ和ＰＣＷＰ均明显高于Ⅱ组和Ⅲ组；而ＣＩ和ＬＶＳＷＩ则低于Ⅱ组和Ⅲ组。结论保留瓣下结构可改善ＭＶＲ术后早期血流动力学，有利于心功能恢复     

大剂量安定与硫喷妥钠—安定诱导对心瓣膜手术病人血流动力…

对４３例ＣＰＢ下心瓣膜直视手术病人进行了血流动力学监测，其中采用大剂量安定诱导（Ｉ组）２２例，硫喷妥钠－安定诱导（Ⅱ组）２１例，诱导后，两组ＣＩ，ＭＰＡＰ，ＰＴＲＩ，ＬＶＷＩ及ＲＶＷＩ均降低，Ｉ组尚伴ＨＲ，ＭＡＰ，ＰＣＷＰ和ＰＶＲＩ下降，Ⅱ组ＲＡＰ及ＳＶＲＩ增加，气管插管后，两组ＲＡＰ，ＰＩＲＩ及ＳＶＲＩ显著增高Ｉ组ＭＡＰ，ＭＰＡＰ，ＰＣＷＰ增高，Ⅱ组ＣＩ下降，锯胸骨后，Ⅱ组ＣＩ，ＬＶＷＩ及ＲＶＷ     

52例严重烧伤休克期血流动力学变化监测

OBJECTIVE: To determine the benefit of hemodynamic monitoring for resuscitation of burn shock. METHODS: A group of 52 burned patients with mean burn area of (69.9 +/- 20.1)% TBSA burn injury (range 31%-100%), and mean III burn area of (60.4 +/- 13.6)% TBSA were included in this study. Swan-Ganz catheters were inserted to monitor hemodynamics including RAP, PAP, PAWP, HR, CO, CI, and SI, etc. after admission at 8, 16, 24, 36, 48, 72, and 96 hours postburn. RESULTS: It was reasonably safe to perform invasive monitoring during early resuscitation. With the guide of hemodynamic monitoring, evidence of global hypovolemia disappeared at 24 hours after burn injury with appropriate resuscitation therapy. CONCLUSION: Invasive hemodynamic monitoring may be necessary to optimize resuscitation of serious burn patients with reasonable safety.     

Cardiovascular effect of 7.5% sodium chloride-dextran infusion after thermal injury.

HYPOTHESIS: Clinical study can help determine the safety and cardiovascular and systemic effects of an early infusion of 7.5% sodium chloride in 6% dextran-70 (hypertonic saline-dextran-70 [HSD]) given as an adjuvant to a standard resuscitation with lactated Ringer (RL) solution following severe thermal injury. DESIGN: Prospective clinical study. SETTING: Intensive care unit of tertiary referral burn care center. PATIENTS: Eighteen patients with thermal injury over more than 35% of the total body surface area (TBSA) (range, 36%-71%) were studied. INTERVENTIONS: Eight patients (mean +/- SEM, 48.2% +/- 2% TBSA) received a 4-mL/kg HSD infusion approximately 3.5 hours (range, 1.5-5.0 hours) after thermal injury in addition to routine RL resuscitation. Ten patients (46.0% +/- 6% TBSA) received RL resuscitation alone. MAIN OUTCOME MEASURES: Pulmonary artery catheters were employed to monitor cardiac function, while hemodynamic, metabolic, and biochemical measurements were taken for 24 hours. RESULTS: Serum troponin I levels, while detectable in all patients, were significantly lower after HSD compared with RL alone (mean +/- SEM, 0.45 +/- 0.32 vs 1.35 +/- 0.35 microg/L at 8 hours, 0.88 +/- 0.55 vs 2.21 +/- 0.35 microg/L at 12 hours). While cardiac output increased proportionately between 4 and 24 hours in both groups (from 5.79 +/- 0.8 to 9.45 +/- 1.1 L/min [mean +/- SEM] for HSD vs from 5.4 +/- 0.4 to 9.46 +/- 1.22 L/min for RL), filling pressure (central venous pressure and pulmonary capillary wedge pressure) remained low for 12 hours after HSD infusion (P = .048). Total fluid requirements at 8 hours (2.76 +/- 0.7 mL/kg per each 1% TBSA burned [mean +/- SEM] for HSD vs 2.67 +/- 0.24 mL/kg per each 1% TBSA burned for RL) and 24 hours (6.11 +/- 4.4 vs 6.76 +/- 0.75 mL/kg per each 1% TBSA burned) were similar. Blood pressure remained unchanged, and serum sodium levels did not exceed 150 +/- 2 mmol/L (mean +/- SD) in either group. CONCLUSIONS: The absence of deleterious hemodynamic or metabolic side effects following HSD infusion in patients with major thermal injury confirms the safety of this resuscitation strategy. Postburn cardiac dysfunction was demonstrated in all burn patients through the use of cardiospecific serum markers and pulmonary artery catheter monitoring. Early administration of HSD after a severe thermal injury may reduce burn-related cardiac dysfunction, but it had no effect on the volume of resuscitation or serum biochemistry values.     

Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration: a randomized, prospective study

HYPOTHESIS: High-dose ascorbic acid (vitamin C) therapy (66 mg/kg per hour) attenuates postburn lipid peroxidation, resuscitation fluid volume requirements, and edema generation in severely burned patients. STUDY DESIGN AND SETTING: A prospective, randomized study at a university trauma and critical care center in Japan. SUBJECTS AND METHODS: Thirty-seven patients with burns over more than 30% of their total body surface area (TBSA) hospitalized within 2 hours after injury were randomly divided into ascorbic acid and control groups. Fluid resuscitation was performed using Ringer lactate solution to maintain stable hemodynamic measurements and adequate urine output (0.5-1.0 ml/kg per hour). In the ascorbic acid group (n = 19; mean burn size, 63% +/- 26% TBSA; mean burn index, 57 +/- 26; inhalation injury, 15/ 19), ascorbic acid was infused during the initial 24-hour study period. In the control group (n = 18; mean burn size, 53% +/- 17% TBSA; mean burn index, 47 +/- 13; inhalation injury, 12/18), no ascorbic acid was infused. We compared hemodynamic and respiratory measurements, lipid peroxidation, and fluid balance for 96 hours after injury. Two-way analysis of variance and Tukey test were used to analyze the data. RESULTS: Heart rate, mean arterial pressure, central venous pressure, arterial pH, base deficit, and urine outputs were equivalent in both groups. The 24-hour total fluid infusion volumes in the control and ascorbic acid groups were 5.5 +/- 3.1 and 3.0 +/- 1.7 mL/kg per percentage of burn area, respectively (P<.01). In the first 24 hours, the ascorbic acid group gained 9.2% +/- 8.2% of pretreatment weight; controls, 17.8% +/- 6.9%. Burned tissue water content was 6.1 +/- 1.8 vs 2.6 +/- 1.7 mL/g of dry weight in the control and ascorbic acid groups, respectively (P<.01). Fluid retention in the second 24 hours was also significantly reduced in the ascorbic acid group. In the control group, the ratio of PaO2 to fraction of inspired oxygen at 18, 24, 36, 48, and 72 hours after injury was less than that of the ascorbic acid group (P<.01). The length of mechanical ventilation in the control and ascorbic acid groups was 21.3 +/- 15.6 and 12.1 +/- 8.8 days, respectively (P<.05). Serum malondialdehyde levels were lower in the ascorbic acid group at 18, 24, and 36 hours after injury (P<.05). CONCLUSIONS: Adjuvant administration of high-dose ascorbic acid during the first 24 hours after thermal injury significantly reduces resuscitation fluid volume requirements, body weight gain, and wound edema. A reduction in the severity of respiratory dysfunction was also apparent in these patients.     

Flüssigkeitstherapie und hämodynamisches Monitoring im Verbrennungsschock

Successful surgical and intensive care treatment of severely burned patients requires adequate prehospital management and fluid resuscitation adjusted to individual needs of the patient. Burn shock fluid resuscitation is now predominantly performed utilizing crystalloid solutions. Whenever possible, colloid solutions should not be given in the first 24 h after burn injury. The rate of administration of resuscitation fluids should maintain urine outputs between 0.5 ml/kg per h and 1 ml/kg per h and mean arterial pressures of >70 mmHg. Extended hemodynamic monitoring can provide valuable additional information, if burn resuscitation is not proceeding as planned or volume therapy guided by these typical vital signs is not attaining the desired effect. We recommend this in patients with TBSA burns of >30%. Inhalation injuries, pre-existing cardiopulmonary diseases, or TBSA burns of >50% definitely require extended hemodynamic monitoring during burn shock resuscitation. The Swan-Ganz catheter or less invasive transcardiopulmonary indicator dilution methods can be utilized to assess hemodynamic data.     

Predicting increased fluid requirements during the resuscitation of thermally injured patients

BACKGROUND: We determined whether factors present soon after burn predict which patients will receive more than 4 mL/kg/% burn during the first 24 hours, and whether total fluid intake during the first 24 hours (VOL) contributes to in-hospital mortality (MORT). METHODS: We reviewed the records of patients admitted during 1987-97. The modified Brooke resuscitation formula was used. One hundred four patients met inclusion criteria: total body surface area burned (TBSA) > or = 20%; admission directly from the field; weight > 30 kg; no electric injury, mechanical trauma, or blood transfusions; and survival > or = 24 hours postburn. Eighty-nine records were complete. RESULTS: Mean TBSA was 43%, mean full-thickness burn size was 21%, mean age was 41 years, mean VOL was 4.9 mL/kg/% burn, and mean lactated Ringer's volume was 4.4 mL/kg/% burn; 53% had inhalation injury. MORT was 25.8%. Mean urine output was 0.77 mL/kg/h. By linear regression, VOL was associated with weight (negatively) and full-thickness burn size (r2 = 0.151). By logistic regression, receipt of over 4 mL/kg/% burn was predicted at admission by weight (negatively) and TBSA; by 24 hours postburn, mechanical ventilation replaced TBSA. With respect to MORT, logistic regression of admission factors yielded a model incorporating TBSA and an age function; by 24 hours postburn, the worst base deficit was added. CONCLUSION: Burn size and weight (negatively) were associated with greater VOL. However, a close linear relationship between burn size and VOL was not observed. Mechanical ventilation supplanted TBSA by 24 hours as a predictor of high VOL. Worst base deficit, TBSA, and an age function, but not VOL, were predictors of MORT.     

伤后即行切痂对烧伤大鼠心肌损伤的防治作用

目的探讨早期一次性切痂对烧伤后心肌损伤的防治作用。方法建立３０％ＴＢＳＡⅢ度烧伤大鼠立即切痂模型,动物随机分为正常对照组、未切痂组和切痂组,于伤后１,３,６,１２和２４ｈ检测血浆肌钙蛋白Ｔ（ＴｎＴ）和肿瘤坏死因子（ＴＮＦ）等指标。结果烧伤后３ｈ血浆ＴｎＴ即显著升高,伤后６ｈ血浆ＴＮＦ显著高于伤前,心肌组织中ＴＮＦ也在伤后１２ｈ显著升高。未切痂组与切痂组比较,伤后１～３ｈ未切痂组ＴｎＴ、ＴＮＦ略低于切痂组,烧伤６ｈ后,未切痂组ＴｎＴ显著高于切痂组,烧伤１２ｈ后,未切痂组ＴＮＦ显著高于切痂组。ＴＮＦ与ＴｎＴ存在显著正相关关系。结论ＴＮＦ是引起烧伤后心肌损伤的重要因素,且与心肌损伤程度密切相关。伤后即行一次性切痂可以减少炎症介质的生成和释放,这可能是其对烧伤后并发心肌损伤具有防治作用的机理之一。     

Experience of immediate burn wound excision and grafting for patients with extensive burns

The treatment of the patients with extensive burns has advanced dramatically in the past 10 years, and the mortality rate has also been reduced. The establishment of the skin-bank network as well as the development of emergency and critical care medicine can be cited as reasons Moreover, immediate burn wound excision and grafting for patients with extensive burns may be beneficial. Meticulous management is required perioperatively to perform these procedures safely during burn shock. Patients with extensive burns are susceptible to hypothermia while receiving massive fluid resuscitation. We use a warmer device (Level 1) to keep burn patients warm. From 1991 to 2003, we performed immediate burn wound excision and grafting in 26 extensively burned patients within 24 hours after burn injury. We completed the surgery within 2 hours and excised burn wounds covering 40% of the total body surface area (TBSA). The mean age was 57 +/- 22 (mean +/- SD years), the mean burn surface area (% of TBSA) was 47 +/- 20, the mean burn index was 45 +/- 19, and the mean prognostic burn index was 94 +/- 36. There were 15 survivors and 11 deaths, for an overall mortality rate of 43%.     

A practical formula for fluid resuscitation in acute paediatric burns in a low resource setting: A pilot study

BackgroundAppropriate fluid resuscitation of acute burn injury is critical and there are recognized challenges with fluid resuscitation, including those with relevance to low resource settings. We developed a practical protocol that guides burn resuscitation and sought to evaluate the safety of our modified resuscitation formula through a small pilot study that particularly addresses the problems we have experienced in a low resource setting.MethodsChildren with burns more than 15% total body surface area admitted within 24 h of injury to Edendale Hospital between 1 June 2021 and 31 August 2021 were included. The resuscitation formula used was 2 mls of Ringers Lactate per bodyweight in kilograms per% total body surface area (TBSA) given over 24 h and adjusted according to urine output. Data analysed included age, weight, mechanism, TBSA, hours post burn at presentation to hospital, total fluid given in the first 24 h of admission, total urine output in the first 24 h of admission, number of fluid adjustments made during the first 24 h and complications related to fluid resuscitation.ResultsTen children were included. The median age was 3 (IQR 2–5) years old, with a mean weight of 14.9 (SD 5.07) kilograms, a median TBSA of 17.4 (IQR 16–26)%, presenting at a median of 12 (6.5–18) hours post burn injury. Mechanism of burn was scald in all cases, with 9 being hot water and hot food in one. In the first 24 h a mean of 2.05 (SD 0.58) mls/kg of fluid was received with a mean urine output of 1.66 (SD 0.57) mls/kg/hr.ConclusionThe results of this pilot study to evaluate the safety of our protocol seem reasonable. It is limited by the lack of larger injuries as well as adult patients and a larger prospective study is pertinent.     

The effects of diaspirin cross-linked hemoglobin on hemodynamics, metabolic acidosis, and survival in burned rats

OBJECTIVE: Diaspirin cross-linked hemoglobin (DCLHb) is a vasoactive hemoglobin-based oxygen carrier or "blood substitute" that has been shown to improve base deficit in several experimental studies of hemorrhagic shock. Our objective was to determine if the addition of DCLHb to the resuscitation regimen would improve hemodynamic parameters, metabolic acidosis, and survival in our rat burn shock model compared with currently used resuscitation therapy. METHODS: This was a randomized, controlled, experimental rat study. Male Wistar rats, weighing 200 to 250 g, were surgically prepared for an acute study. After placement of indwelling catheters, baseline hemodynamic values (mean arterial pressure, cardiac output, systemic vascular resistance, stroke volume, and base excess) were obtained. Thirty-two rats were used in the study, and they were either subjected to a 30% scald burn (experimental group) or sham burned (control group). The experimental animals were immediately intravenously resuscitated and followed for 6 hours. The resuscitation was based on the Parkland formula (4 mL/kg for each 1% of total body surface area [TBSA] burn), with 50% of the calculated fluid amount to be administered at a constant rate during the first 8 hours after burn. The animals were resuscitated for 6 hours and received between 9.00 and 11.25 mL of fluid depending on weight. The experimental animals were randomly assigned to one of three treatment groups: group I, lactated Ringer's solution; group II, lactated Ringer's solution-human serum albumin; group III, lactated Ringer's solution-DCLHb. Group I (n = 8) received 4 mL/kg lactated Ringer's solution for each 1% of TBSA burn. Group II (n = 8) received 2 mL/kg lactated Ringer's solution and 2 mL/kg human serum albumin for each 1% of TBSA burn. Group III (n = 8) received 2 mL/kg lactated Ringer's solution and 2 mL/kg DCLHb for each 1% of TBSA burn. The sham group (n = 8) was not burned and was not resuscitated. Animals that survived up to 6 six hours were killed. RESULTS: We found that mean arterial pressure, cardiac output, stroke volume, and base excess were all improved in the DCLHb-lactated Ringer's solution-treated animals compared with the other experimental treatment groups. The 6-hour mortality rates were zero of eight (lactated Ringer's solution-DCLHb group), zero of eight (sham group), three of eight (lactated Ringer's solution-human serum albumin group), and six of eight (lactated Ringer's solution only group). CONCLUSION: Early resuscitation with DCLHb is superior to non-oxygen-carrying resuscitative fluids in improving hemodynamics and survival in this model of burn shock. DCLHb might improve general tissue perfusion in the acute postburn period, and it could be useful in the early management of patients with severe burns.