The role of the heat factor in the pathogenesis of burns

Abstract

Abstract Background: Under the action of the increasing temperature and multiple stress factors, the quantity of catalyzing hormones suddenly increases, as well as the hydrolysis of carbohydrates, lipids and proteins. A large amount of energy is liberated in the body. A large surplus of energy is formed, which cannot be used by the body. It must be liberated in the surrounding environment. But, in tropical conditions, where atmosphere is extremely loaded with thermal energy, its liberation is very limited. Material and methods: The investigations were performed on 427 patients in tropical climatic conditions and on 80 patients in continental climatic conditions. The hyperthermia state was determined immediately after the trauma, in its dynamics during the transportation in a shock state, at hospitalization and in the evolution of the combustions. At the same time, the catabolic reaction in the vascular system was determined by means of establishing the capillary structure, ascertained histologically. Results: The obtained results showed that the tropical climate exerts a very big influence on the organism of the patient with combustions. Among all the patients with combustions in the tropical area, in 71% of them a surplus of thermal energy took place, which manifested from the first minutes after the trauma. Body temperature in these patients increased up to 38-39ºC. It maintained during the first 24 hours and, only after intensive treatment in conditioned air, it decreased. At the same time, it was established that catabolism was very advanced, especially in the structure of the capillary wall, which was manifested by aggravated plasmorrhea, ascertained histologically and according to the hemoconcentration degree, the function of the respiratory and cardiovascular system, and the excretion of mineralocorticoids. Conclusions: In tropical conditions, accumulation of thermal energy in the organism of the patients with combustions is very accelerated, even when up to 10% of the body surface is affected, body temperature can reach 39-40ºC from the first hours after the trauma. The method of providing first aid by using hypothermia in patients with combustions is very necessary in order to decrease both locally, and generally the catabolic processes.