Third Degree Burns and Dehydration

Here is an informative article for anyone who suffers injuries from severe burns–not just soldiers who are burned in combat:

Many American soldiers who suffer burns during combat develop acute kidney injury–an abrupt or rapid decline in kidney function that is potentially deadly. That’s the finding of a study that looked at acute kidney injury among 692 U.S. military casualties who were evacuated from Iraq and Afghanistan to burn units.

Using two different classification systems, the researchers found that rates of acute kidney injury were 24 percent and 30 percent among the casualties. What’s more, those with acute kidney injury were much more likely to die than those without it. Death rates among patients with moderate forms of kidney problems were 21 to 33 percent, while severe forms of the condition were made the death rate a whopping 63 to 65 percent. In comparison, the death rate for patients who did not have acute kidney injury was 0.2 percent.

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The two most important problems encountered clinically with burned patients are infection and dehydration. When a person is burned and depending on the severity of burn, the blood vessels including the capillaries may be affected. Combined with the release of chemical substances into the blood, this will lead to increased capillary permeability to fluids, leading to the leaking of fluids from the blood vessels into the tissues. The higher the percentage of burned skin, the more severe the loss of fluid will be and the greater the dehydration will be.

In a third degree burn the entire thickness of skin (epidermis and dermis) is involved and nerve endings have been destroyed. The body’s barrier against water loss is no longer there. When the protective covering does not exist, fluid seeps from the burned area causing dehydration and electrolyte imbalance. Unless fluids are replaced immediately, renal shut down and hypovolemic shock will occur. Skin is both a physical barrier, preventing water loss, and also a chemical barrier, preventing the growth of bacteria.

Fluid replacement is one of the important objectives in the initial treatment of burned patients. The amount of fluid needed and the method of fluid given depends on the surface area of the skin burned as well as other factors. There are many formulas used to calculate the amount of fluid needed for resuscitation; one of them is called the Parklund Formula in which after the amount of fluids is calculated, it is given through an IV route and the type of fluid is usually Ringer Lactate because it’s composition is simillar to the extracellular fluid.

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Third Degree Burns and Dehydration