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The investigation was undertaken to study the effects of perfluorane on the degree of endogenous intoxication in the severely burnt. Sixty-five victims aged 20 to 55 years who had burns of the skin, involving more than 30% of the body surface area, without comorbidity (less than 9 SAPS scores), were examined. All the examinees were divided into 2 groups. They were comparable in age and burn injury degree. Perfluorane was administered in a dose of 4 ml/kg body weight within the first 24 hours after the moment of injury (a study group; n = 30). During the investigation, the authors estimated blood gas composition and acid-base balance, the level of lactate in mixed venous blood, the content of low and medium molecular-weight substances (LMMWS) in venous and arterial plasmas, on red blood cells and urine; erythrocytic deformity index; the level of reduced glutathione; total plasma antioxidative activity, and the plasma concentration of malonic dialdehyde. Blood was sampled on admission, an hour after administration of perfluorane, and onwards--on days 1, 3, 5, 7, 10, and 15. Perfluorane used in acute burn disease leads to normalization of oxygen balance, a reduction in the rate of free radical oxidation and lipid peroxidation, and a considerable decrease in LMMWS levels on the red blood cell membranes and plasma. Positive changes were recorded just an hour after administration of perfluorane and retained throughout the observation. In the study group victims, mortality was 15% less than that in the controls.

A hundred and twenty-nine victims aged 16 to 60 years who had skin burns in the area of 15 to 60% of the body surface without severe concomitant somatic disease (SAPS less than 9 scores). The clinical symptoms of a systemic inflammatory response (SIR) and the signs of wound infection were recorded in all the examinees. The victims underwent a comprehensive clinical and laboratory examination, 55 of them were immunologically studied over time (on admission, on days 3 and 10). To reveal the predictive clinical and immunological criteria for sepsis, the examinees were divided into 3 groups. Group 1 comprised 33 burnt persons who were observed to have the symptoms of SIR and the signs of burn wound infections without impaired function of organs and systems. Group 2 included 46 victims with severe sepsis and a good outcome of burn disease. Group 3 consisted of 50 patients who had died from severe sepsis. Analysis of the results of the study has indicated that the count of formed blood elements by calculating the leukocytic intoxication index, the estimation of the level of lysosomal cation proteins in the neutrophilic granulocytes, the detection of populations of T helper cells, cytotoxic lymphocytes, as well as histomorphological and bacteriological findings are early and valid criteria for the development of infectious complications. Their use for the diagnosis and prediction of sepsis permits initiation of its treatment at early stages, without awaiting the appearance of the signs of a septic process.

Sixty-seven therapeutic fibrobronchoscopies (FBS) were carried out in burnt patients with suspected inhalation injuries at Center for Burns at the Janelidze Institute of Emergency Care in 1996-1998. The severity of inhalation injury was assessed from the extent and severity of mucosal edema, spot hematomas and their type, erosions and ulcers, discharge, and ventilation obstruction. An original score is developed for evaluating the severity of inhalation injuries in burnt patients. Inhalation injuries were diagnosed in 63 patients. FBS was performed with tracheobronchial lavage with antibiotics, proteolysis enzymes, and repair stimulants. Mortality among burnt patients with inhalation injuries was decreased to 38%.