Experimental Evaluation of the Effectiveness of Antishock Therapy for Severe Combined Mechanical and Thermal Injury

BACKGROUND: Modern combat-related surgical trauma is characterized by the combined impact of multiple detrimental factors. This often leads to the simultaneous development of several critical conditions in the body, such as burn disease and crush syndrome. The cross-interaction of these pathogenetic pathways contributes to the development of mutual aggravation syndrome, thereby increasing the likelihood of an unfavorable trauma outcome. Research into the mechanisms of these conditions and the development of pathogenetically justified approaches to correcting these homeostatic disturbances remains highly relevant.

AIM: To evaluate the effectiveness of antishock therapy in a combined experimental model of crush syndrome and burn disease.

METHODS: The study was performed using 360 rats weighing 240–250 g, in which both crush syndrome and deep skin burns were induced. Mortality rates were analyzed depending on the volume and composition of the antishock therapy delivered. Data processing was performed using the standard methods for variation statistics. The alternative hypothesis was accepted at p < 0.05.

RESULTS: It was found that in the combined model of crush syndrome and burn disease, the volume of infused fluids should be increased by 40%. Based on this result, the standard Parkland formula was modified to V = 6,5 × S × M. Among the evaluated antishock therapy regimens, the combination of crystalloid and colloid solutions in a 40:60 ratio exhibited the highest efficacy. The mortality rate in this group was 28.9%, which was 2.4 (p < 0.05) and 2.6 (p < 0.05) times lower than that with 0.9% sodium chloride solution and 10% albumin solution, respectively. The high effectiveness of the substrate-based antihypoxants for the treatment of mechanical and thermal shock was demonstrated. Their administration reduced the mortality rate to 30.4%, which was 2.2 times (p < 0.05) lower than the results observed when normal saline was administered. The use of analgesics and antioxidants did not significantly influence the animals’ survival rate.

CONCLUSION: The results of this study indicate the potential use of metabolic (substrate-based) antihypoxants in antishock therapy for patients with combined crush syndrome and burn disease. This research direction requires further development and in-depth investigation.