What causes hemoglobinuria after extensive burns, and how should it be managed?

Hemoglobinuria following extensive burns may result from red blood cell destruction, or could be caused by factors such as nephritis or hemolytic transfusion reaction. It is essential to follow medical advice and choose appropriate treatment methods promptly. Specific analyses are as follows:

1. Red Blood Cell Destruction

When the body suffers extensive burns, a large number of red blood cells in circulation may be destroyed, causing hemoglobin levels to exceed the binding capacity of haptoglobin. The excess hemoglobin is then filtered through the glomeruli, leading to hemoglobinuria. In such cases, fluid replacement therapy should be administered according to medical guidance, along with appropriate sodium bicarbonate supplementation to alkalinize the urine.

2. Nephritis

If the patient already has nephritis and remains untreated for a prolonged period, kidney damage may develop, which is often associated with red blood cell lysis and can manifest as hemoglobinuria. Treatment in such cases should follow medical recommendations and may include medications such as Nephritis Recovery Tablets, Desmopressin Acetate Tablets, and Uremic Clearance Granules.

3. Hemolytic Transfusion Reaction

Following extensive burns, severe blood loss may occur, necessitating blood transfusion. If incompatible blood types are transfused, hemolysis may result, triggering a hemolytic transfusion reaction and subsequent hemoglobinuria. Immediate cessation of transfusion is required, intravenous access should be maintained, and intravenous immunoglobulin should be administered as directed by a physician to improve the condition.

In addition, hemoglobinuria may also be caused by other factors such as sepsis, infective bacterial endocarditis, or renal infarction. Prompt medical evaluation and symptomatic treatment are necessary.