Treatment of Burn Shock with Plasma and Serum

The use of plasma or serum protein in the treatment of shock from extensive burns has frequently been advo- cated, and there is ample theoretical justification for protein-containing infusions, in view of the constant presence of haemoconcentration and reduced plasma volume in any severe burn. Nevertheless, published accounts of the effects of such treatment are few, and the data given are somewhat incomplete, particularly with regard to blood volume and serum electrolyte concentra- tion. Trusler et al. (1940) and Elkinton (1939) have each reported two patients who were treated by plasma infusion with benefit. This paper deals with eight patients with burns or scalds, of whom seven were treated by plasma or serum, or both. The. plasma used was obtained by separation irom blood taken into standard M.R.C. bottles contain- ing 180 c.cm. of citrate solution, so that the final product may best be described as " half-strength plasma." The solution of serum protein was made up by the addition of sterile water to dried serum, and the solution used was four times the concentration of the original serum. The schedule of investigations which we proposed to our- selves included the determination of blood and plasma voltme, haematocrit, haemoglobin and red cells, protein and albumin, chloride, bicarbonate and urea, sodium and potassium. These were to be determined before and after the infusion of plasma or serum and after complete recovery from the burn. It was not possible to carry out the full programme in all cases, since one or both arms were often involved in the burn; but a complete record was obtained in Cases 3 and 5; and, with the exception of blood volume, all the proposed data were obtained in the other cases. Besides the blood examination, records were kept of the pulse and blood pressure, and frequent notes of the patient's general condition were taken.