Blast-Burn Combined Injury Followed by Immediate Seawater Immersion Induces Hemodynamic Changes and Metabolic Acidosis: An Experimental Study in a Canine Model.

BACKGROUND: Severe burn-blast combined injury often causes systematic dysfunction related to blood coagulation, anticoagulation, and fibrinolysis. However, studies of burn-blast combined injury followed by immersion in seawater are rarely reported.

METHODS: A canine burn-blast combined injury model was established including blast injury caused by explosion immediately followed by burning with gelatinized gasoline flames. The dogs were randomly divided into four groups: burn-blast injury (BB group); burn-blast injury followed by seawater immersion for four hours (BBI group); only immersed in seawater (I group); and sham treatment with no injury or immersion (S group). Rectal temperature, hemodynamic parameters, arterial blood gas levels, and respiratory function were measured.

RESULTS: The dogs in the BB group showed relatively more stable hemodynamic features than those in the BBI group. The pH, base excess (BE), HCO3-, PaO2, and PaCO2 levels in the S, I, and BB groups after injury did not differ from those before injury (p > 0.05). The PaO2 level in the BBI group decreased initially after injury and returned to a normal level by 10 hours after injury. The pH, BE, HCO3-, and PaCO2 values in the BBI group decreased continuously after injury and were significantly less than those in the other groups (p < 0.05).

CONCLUSIONS: Burn-blast combined injury followed by seawater immersion induced hemodynamic changes and metabolic acidosis. Knowledge of the early symptoms and unique pathophysiology of the combined injury will be valuable in determining the appropriate management of such patients. Level of evidence: Prognostic study, level IV.