Delayed fluid resuscitation of burn shock may lead to infection in early period following major burn injury, resulting in multiple organ failure with high mortality. The change in colony stimulation factors (CSFs) may play a role in developing infection. We assessed the levels of serum granulocyte colony stimulation factor (G-CSF), tumor necrosis factor-alpha (TNF-alpha), phagocytosis of neutrophil and counts of peripheral blood cells of rats with 30% TBSA full thickness burn having either immediate or delayed fluid replacement. We also evaluated the efficacy of granulocyte-macrophage colony-stimulating factor (GM-CSF) in improving survival of rats following burn injury with a superimposed burn wound infection.
The results: 1. A delayed rise in serum G-CSF was found in delayed resuscitation group, and the levels of serum G-CSF and phagocytosis of neutrophil were lower compared with immediate resuscitation group. 2. Nonsurvival group had lower levels of serum G-CSF and higher content of TNF-alpha compared with survival. 3. Supplement of GM-CSF could significantly improve animal survival with burn wound infection following severe burn shock.
Conclusion: Decrease in G-CSF production plays a role in developing fatal wound infection after severe burn shock; supplement of GM-CSF is beneficial in improving survival.