小児熱傷に対する初期輸液療法の臨床的検討

抄録

Thirty-three pediatric burn patients were managed by a newly planned initial hydration formula modified from Shriner's formula. In this new formula, the maintenance fluid volume was increased to 2,400ml per body surface area (m2) from 2,000ml of Shriner's. The patients were divided into two groupes, in Group 1 (16 patients) 4.5% glucose was added, while in Group 2 (17 patients) no glucose was added in initial hydration in order to clarify the disadvantages of glucose addition into resuscitation fluid for burn shock. The results of this study are summarized as follows : 1) All patients were resuscitated well from burn shock without any more volume increment, and no critical cardiopulmonary complication occurred in refilling period. 2) In Group 1 (4.5% glucose added) hyperglycemia, glucosuria, polyuria, and other metabolic adverse reactions were prominent in comparing to Group 2. 3) Although albumin was added in the same volume as Shriner's formula, serum protein and colloid osmotic pressure fell into profoundly low level. But it's addition was considered to contribute to maintaining the circulating blood volume without any more fluid increment. In conclusion, this newly planned initial hydration formula is very proper for pediatric burn resuscitation, but no glucose should be added in it.