Mechanisms of Burn Shock Protection after Severe Scald Injury by Cold-water Treatment

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Abstract
Following a 3-s subxiphoid immersion of shaved, unresuscitated guinea pigs in 100.degree. C water, cardiac output (CO), mean systemic blood pressure (BP), total peripheral resistance (TPR), hematocrit (HCT), serum histamine (SH), and serum lactate (SL) were measured in untreated and cold-water treated animals up to 24 h after injury. Animals receiving cold-water treatment (CWT) were immersed in 15.degree. C water for 15 min immediately after scald injury. CWT significantly (P < 0.05) reduced SH and SL for up to 8 and 24 h, respectively, after injury compared to untreated injured animals. HCT of CWT animals remained significantly lower than that of untreated animals for the first 8 h after injury. CWT-animal HCT was not significantly different from control-animal HCT for this same period. CWT-animal BP was significantly greater than untreated-animal BP for the first 8 h after injury. CWT- and untreated-animal TPR progressively rose after injury; however, at 24 h after injury CWT-animal TPR was significantly reduced to 87% .+-. 18.0 of preinjury values while untreated-animal TPR was maximally elevated to 170% .+-. 10.0 of preinjury values. At 4 h after injury CO of both untreated and CWT animals was significantly depressed at 56% .+-. 3.0 and 50% .+-. 10.0 of preinjury values, respectively. By 24 h after injury untreated-animal CO remained depressed at 52% .+-. 3.0 while CWT-animal CO was significantly improved at 92% .+-. 19.0 of preinjury values. These studies document a beneficial hemodynamic response of severely burned animals after CWT and further verify the phenomenon of cold inhibition of burn wound tissue histamine release after severe scald injury. A correlation between decreased serum histamine and lactate levels and improved cardiovascular function following severe scald injury and CWT is also suggested.