Burns: Military options and tactical solutions

Steven J. Thomas, George C. Kramer, David N. Herndon

Research output: Contribution to journalArticlepeer-review

62 Scopus citations


Burn injury remains a constant source of morbidity and mortality in the military environment. The logistic constraints of combat casualty care can make it impossible to provide the large volumes of crystalloid typically used for burn resuscitation. Unlike penetrating trauma, the immediate and sustained fluid requirements necessary for resuscitation of thermal injury preclude the use of limited or hypotensive resuscitation. We examine the physiology, traditional resuscitation strategies, and rationales for the use of novel regimens in the resuscitation of thermal injury. Although strategies such as early use of colloids or hypertonic saline may not reduce morbidity or mortality when compared with large-volume infusions of lactated Ringer's, they can be volume sparing for some hours and sustain life until more definitive therapy is initiated. An intriguing hypothesis is that oral resuscitation can effectively restore plasma volume after thermal injury. We present data from recent experiments of gastric and intestinal infusions of an oral rehydration solution in a porcine burn model that demonstrates restoration of plasma volumes and improvement in hemodynamic parameters associated with significant gastric emptying and intestinal absorption.

Original languageEnglish (US)
Pages (from-to)S207-S218
JournalJournal of Trauma - Injury, Infection and Critical Care
Issue number5 SUPPL.
StatePublished - May 1 2003


  • Burn
  • Hypertonic saline
  • Military trauma
  • Oral rehydration
  • Pathophysiology
  • Resuscitation
  • Treatments

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine


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