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

Xiang-Yu Liu; Yu-Shou Wu; Jia-Ke Chai; Xiao-Wei Su; Yi-Rui Qu; Fang-Chao Hu; Tian Liu; Jin-Guang Zheng; Shao-Fang Han; Hui Zhou; Yun-Fei Chi

doi:10.1016/j.burns.2025.107615

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

Burns. 2025 Jul 9;51(7):107615. doi: 10.1016/j.burns.2025.107615. Online ahead of print.

Authors

Affiliations

¹ Graduate School, Chinese PLA General Hospital, Fuxing Road 28, Haidian District, Beijing 100853, China; Senior Department of Burns & Plastic Surgery, Institute of Burn in the Fourth Medical Centre, Chinese PLA General Hospital, Fucheng Road 51, Haidian District, Beijing 100048, China.
² Senior Department of Burns & Plastic Surgery, Institute of Burn in the Fourth Medical Centre, Chinese PLA General Hospital, Fucheng Road 51, Haidian District, Beijing 100048, China. Electronic address: cjk304@126.com.
³ Senior Department of Burns & Plastic Surgery, Institute of Burn in the Fourth Medical Centre, Chinese PLA General Hospital, Fucheng Road 51, Haidian District, Beijing 100048, China.
⁴ Senior Department of Burns & Plastic Surgery, Institute of Burn in the Fourth Medical Centre, Chinese PLA General Hospital, Fucheng Road 51, Haidian District, Beijing 100048, China. Electronic address: chi_yunfei@126.com.

PMID: 40651116
DOI: 10.1016/j.burns.2025.107615

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Burn; Oral rehydration therapy; Preclinical research; Prehospital emergency care; Shock; Teprenone.