Preliminary exploration of efficacy assessment and optimal concentration of teprenone oral rehydration solution for the early management of post-burn shock.

Abstract

To evaluate therapeutic efficacy of teprenone-enriched oral rehydration solution (TORS) relative to World Health Organization's recommended Oral Rehydration Solution (WHO-ORS) and identify the optimal concentration of TORS for early burn shock intervention. A total of 350 male Wistar rats (200-220 g) were randomly divided into seven groups (n = 50/group): Sham (no burn and no treatment) group, Burn (no treatment) group, WHO-ORS group, and four concentrations of TORS (TRS1-TRS4). All groups, except Sham group, were subjected to 50 % total body surface area (TBSA) third-degree scald burns. Resuscitation protocols commenced immediately post-burn and continued every 2 h for 8 h, delivering TORS at 2 mL/kg/%TBSA (modified Brooke formula). Survival rates were measured at 72 h post-burn. High-resolution laser Doppler was used for gastric blood flow measurement; gastrointestinal mucosal damage was assessed via optical and transmission electron microscopy; blood teprenone levels were determined using reverse-phase high-performance liquid chromatography. Lactate, hematocrit, hemoglobin, malondialdehyde, superoxide dismutase, and interleukin-33 levels were analyzed. TORS administration resulted in higher 72- h survival rates in both Burn and WHO-ORS controls (P < 0.01 for TRS2 vs Burn), while exhibiting dose-dependent serum teprenone absorption. All TORS groups exhibited improved gastric blood flow, reduced gastric mucosal damage, and better performance in other measured parameters than the WHO-ORS group and Burn group. The TRS2 concentration was closest to the Sham group in most of the studied parameters. The newly formulated TORS proved to be effectively emptied and absorbed by the gastrointestinal tract. This study establishes TORS as a viable oral resuscitation strategy, with TRS2 demonstrating optimal efficacy in improving tissue perfusion and survival outcomes over WHO-ORS, thereby offering a promising approach for early burn shock management. Further investigations are required to elucidate its underlying mechanisms.