New concepts in therapy for electrical shock

High-voltage electrical trauma often causes extensive and scattered tissue destruction along the current path through the body. The first objective of therapy must be to seal the damaged membranes. There are several blood-compatible polymers known to bind to damaged cell membranes. Dextran and poloxamer 188 are the best-known clinically. Because they seal electropermeabilized membranes, they may have therapeutic benefit in electrical injury. In the future, new guidelines for treating electrical trauma will be based on a clearer picture of the relevant pathophysiology. These strategies will rely on improved diagnostic imaging and on reversing the fundamental problem of cell membrane damage. Moreover, complex biochemical and organ system pathophysiological interactions will have to be carefully managed. Research is presently directed towards improving understanding of these basic issues. If successful, these efforts should tremendously improve the prognosis of victims following electrical trauma.