Intravascular hemolysis has been reported in horses following severe cutaneous burns affecting more than 25% of their body surface.
Blood samples on admission showed hemolysis along with abnormal RBC morphology, increased osmotic fragility, hemoglobinuria, azotemia, and hemoglobin pigment nephropathy.1 The pathophysiology of hemolysis is unclear but suspected to be associated with the production of hydroxyl radicals by complement-activated neutrophils.
Abnormal findings reported in humans include intravascular hemolysis, increased RBC osmotic fragility, decreased membrane deformability, RBC crenation, eccentrocytosis, spherocytosis, bud formation, fragmentation, and vesicula- tion.2 These abnormalities are dependent on severity of burn trauma.2 Early fluid therapy and free radical scavengers have been beneficial for burn treatment in humans, along with supportive and wound care, control of pain and inflammation, and sepsis prophylaxis. A study in mice suggests that the level of plasma free hemoglobin is related to the size and depth of burn injury, which may be difficult to determine in some cases.3
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