BACKGROUND

Acid-base disturbances accompany various critical illnesses, including severe burn injury, and result metabolic acidosis. In all victims with burn injury and shock, severity of metabolic lactate acidosis depends on severity of injury and timeliness of intensive therapy. Normalization of acid-base balance is one of the objectives of therapy.

OBJECTIVE

To analyze severity of acid-base disorders in patients with burn injury and shock in acute period of burn disease and develop the best option for correction.

MATERIAL AND METHODS

A prospective analysis included 65 severely burned patients who underwent standard laboratory testing including analysis of acid-base balance. Correction of disorders implied infusion of 4% sodium bicarbonate in patients with pH <7.25 or meglumine sodium succinate in those with pH 7.25—7.35. Doses of drugs for correction were calculated depending on bicarbonate deficiency.

RESULTS

We confirmed metabolic lactic acidosis as predominant type of acid-base imbalance (pH 7.27 (6.98; 7.31), lactate 4.5 (2.8; 5.1) mmol/l, bicarbonate 17 (14.4; 20.4) mmol/l). There was subcompensation of these disorders in most patients, so correction included meglumine sodium succinate with positive dynamics and normalization of parameters after 3 days.

CONCLUSION

Lactic acidosis occurred in all severely burned in acute period of burn injury. Subcompensated metabolic acidosis not requiring correction with sodium bicarbonate prevails. Acid-base disorders are successfully corrected by infusion of 1.5% solution of meglumine sodium succinate.