Mechanism of acute erythrocyte loss following burn

Direct measurements of red cell mass, osmotic fragility change and plasma hemoglobin immediately following a 22 cal/cm 2 30% surface area burn in the dog indicate that a 13% decrease in red cell mass occurs, at least half of which can be attributed to the direct destruction and changes in osmotic fragility of erythrocytes. It was also observed that the red cell mass may increase following burn as a result of splenic extrusion of sequestered erythrocytes. The results of these experiments indicate that while there is some physiologic basis for whole blood therapy following burn, the more immediate requirement is the replacement of fluid.