To investigate the efficacy of early use of human serum albumin in severe burn patients with burn shock.

A total of 77 inpatients with severe burns admitted to the Department of Burns and Plastic Surgery, Shizuishan First People′s Hospital Affiliated to Ningxia Medical University from January 2019 to October 2021 were selected as the research objects, and the patients were randomly divided into the experimental group and the control group by random number table method, with 41 cases in the experimental group, 36 cases in the control group. After admission, all patients received anti-infective treatment to protect the function of various organs, monitored various physiological indicators of patients, and bandaged the wound with silver ion dressing. In the experimental group, 50% of the colloidal fluid in the 1st 24 hours after burn was infused with hydroxyethyl starch 130/0.4 sodium chloride solution and fresh frozen plasma within 8 hours of the burn, and the remaining 50% of the colloid was infused within 16 hours of the burn, the human albumin solution was infused 12 hours after the burn; the amount of colloid in the 2nd 24 hours was infused with fresh frozen plasma+ human albumin solution; the 3rd and 4th 24 hours were supplemented with human albumin according to blood routine and biochemical tests. In the control group, 50% of the colloid volume in the 1st 24 hours after burn was infused with 500 mL of hydroxyethyl starch 130/0.4 sodium chloride solution and fresh frozen plasma within 8 hours of burn, and the remaining 50% of the colloid volume (fresh frozen plasma) was infused within 16 hours of burn; the amount of colloid in the 2nd 24 hours was the fresh frozen plasma and human albumin solution, and human albumin was infused after 36 hours of burn; the 3rd and 4th 24 hours were based on blood routine and biochemical examinations supplement human serum albumin. The colloidal fluid volume, total fluid intake, albumin supplementation volume, and hourly urine volume in the 1st, 2nd, 3rd, and 4th 24 hours after burn in the two groups of severe burn patients were counted; serum albumin content in the 1st, 2nd, 3rd, and 4th 24 hours after burn, and hematocrit, hemoglobin, platelets, and C-reactive protein after 48 hours of burn were recorded; the shock index after 48 hours of burn in the two groups was calculated. Data were compared with unpaired samples t-test or nonparametric test.

In the 1st, 2nd, 3rd, and 4th 24 hours after burn injury, the amount of colloidal fluid in the experimental group were (0.37±0.15), (0.23±0.10), (0.07±0.01), and (0.02±0.01) mL·kg^-1·%TBSA^-1, respectively, all less than the control group [(0.58±0.17), (0.29±0.09), (0.08±0.01), (0.05±0.01) mL·kg^-1·%TBSA^-1], the differences between the two groups were statistically significant (t=5.759, 2.752, 4.378, 13.130; P<0.05); at the 1st, 2nd, 3rd, and 4th 24 hours after burn, the total fluid intake in the experimental group were (2.31±0.21), (1.56±0.10), (1.01±0.13), (1.02±0.13) mL·kg^-1·%TBSA^-1, which were all less than the control group [(2.55±0.22), (1.62±0.14), (1.13±0.25), (1.09±0.25) mL·kg^-1·%TBSA^-1], the differences were statistically significant (t=4.894, 2.183, 2.689, 1.568; P<0.05). The amount of albumin supplemented in the 1st and 2nd 24 h after burn in the experimental group were (76.64±4.26), (67.43±7.20) g, which were higher than the control group [(62.57±4.43), (55.72±4.89) g], the differences were statistically significant (t=14.190, 8.230; P<0.05). The amount of albumin supplementation in the experimental group in the 3rd and 4th 24 h after injury were (44.07±4.46) and (24.49±5.25) g, respectively, which were lower than those in the control group. group [(46.68±6.06), (38.65±7.01) g], the differences were statistically significant (t=2.169, 10.110; P<0.05). The urine volume in the 1st, 2nd, and 3rd 24 hours after burn in the experimental group were higher than that in the control group, and the urine volume in the 4th 24 hours after the burn was lower than that in the control group, and the differences were statistically significant (t=2.363, 2.194, 3.591, 11.170; P<0.05). At the 1st, 2nd, 3rd, and 4th 24 hours after burn, the serum albumin content of the experimental group were higher than that of the control group, and the differences were statistically significant (t=2.505, 4.517, 40.140, 3.544; P< 0.05). After 48 hours of burn, the hematocrit, hemoglobin, and C-reactive protein in the experimental group were (36.57±6.48)%, (121.16±13.16) g/L, and (209.54±32.57)×10⁹/L, respectively, compared with the control group [(39.83±7.47)%, (134.64±18.94) g/L, (116.72±39.84)×10⁹/L], and the differences were statistically significant (t=2.051, 3.662, 5.003; P<0.05); the platelet level in the experimental group was (30.67±9.27) mg/L, which was higher than that in the control group [(40.52±7.69) mg/L], and the difference was statistically significant (t=11.240, P<0.05). After 48 hours of burns, the shock index of the experimental group was 0.64±0.13, and the shock index of the control group was 0.76±0.12, the experimental group was significantly lower than the control group, and the difference was statistically significant (t=4.189, P<0.05).

The use of human albumin in the early stage of burn shock can effectively expand the volume, correct hypoalbuminemia, reduce the total amount of fluid resuscitation, restore organ insufficiency, and provide favorable conditions for the treatment of severe burn patients.