Dereglările hidroelectrolitice la pacienţii cu arsuri în diferite condiţii climaterice

Abstract

Background: It is well-known that the influence of the tropical, subtropical or continental climate is reflected, first of all, on the hydroelectrolytic metabolism. In case of combustions, these losses are very pronounced, depending on the surface affected. Material and methods: The studies were performed in 1286 patients with combustions in tropical conditions (Cuba, Guinea) and in diametrically opposed, continental climatic conditions (Moldova, Moscow, Kharkov). The indices of K(+), Na(+), cations and Cl(-) anions were determined. Also, other parameters were assessed, such as hemoconcentration according to hematocrit and hemoglobin, histologically – capillary permeability, protein metabolism and clinical manifestations, such as somatic state, muscular reflexes and the state of the CNS. Results: In tropical climatic conditions, in patients with combustions, during the first hours after the trauma, especially in severe lesions, hyperkalemia and severe hemolysis take place, and, after 3-4 days, the potassium level sharply decreases and it is clinically manifested by a decrease in the neuromuscular reflexes, protein synthesis is also decreased, which is expressed by hypoproteinemia, adynamia continues to progress, dyspnea is increased, arrhythmia and, frequently, hallucinations also take place. Conclusions: Electrolytic indices in patients with combustions in the tropical area, both the cations (K(+), Na(+)), and the anions (Cl(-)), are much more altered compared to the patients with combustions in the continental area. In tropical conditions, as a result of the generalized catabolism, the capillary vessel walls are severely affected and liquid losses are very extended. Hemoconcentration in patients with combustions from the tropical area is much more pronounced compared to the patients with combustions in the continental area.