Is supra-Baxter resuscitation in burn patients a new phenomenon?

Friedrich, Jeffrey B.; Sullivan, Stephen R.; Engrav, Loren H.; Round, Kurt A; Blayney, Carolyn B; Carrougher, Gretchen J.; Heimbach, David M.; Honari, Shari; Klein, Matthew B.; Gibran, Nicole S.

doi:10.1016/j.burns.2004.01.021

Cited by 102 publications

(43 citation statements)

References 13 publications

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“…20,25 In this project, the incidence of ARDS within the first 5 days of admission was 30% in the preimplementation group and was reduced to 10% in the postimplementation group. After review of data, we found that the preimplementation group had more patients with inhalation injuries (47%) than the postimplementation group (38%), which may have contributed to the improved outcomes.…”

Section: Discussionmentioning

confidence: 85%

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Implementation of a Nurse-Driven Burn Resuscitation Protocol: A Quality Improvement Project

Fahlstrom

Boyle

Makic

2013

Critical Care Nurse

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Background Burn resuscitation, including titration of fluids and administration of colloids, is often driven by physicians’ orders. Inconsistencies in burn resuscitation cause overresuscitation, which has adverse consequences. Methods Retrospective chart reviews were completed to evaluate fluid resuscitation and complications for 12 months before and after development and implementation of a nurse-driven burn resuscitation protocol. Results Before implementation of the protocol, results at 24 hours after injury indicated that 58% of patients were overresuscitated, had a serum level of lactate of at least 2 mmol/L (100%), and had complications (pulmonary edema 20%, abdominal compartment syndrome 7%, acute lung injury/acute respiratory distress syndrome 30%) within the first 5 days. Two outcomes differed from before to after implementation of the protocol: serum level of lactate at 24 hours (t37.8 =2.38, P =.007) and central venous pressure at 48 hours (t31 =2.27, P =.03). After implementation of the protocol, no patients had abdominal compartment syndrome develop. Conclusions Implementation of the nurse-driven burn resuscitation protocol improved nurses’ awareness and assessment of fluid status during resuscitation and improved patients’ outcomes.

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Section: Discussionmentioning

confidence: 85%

“…7,19 This phenomenon has also been termed "supraBaxter resuscitation." 20 Complications associated with overresuscitation include pulmonary edema, ARDS, acute lung injury, abdominal hypertension, abdominal compartment syndrome, longer duration of mechanical ventilation, and longer ICU stays. 13 …”

Section: Introductionmentioning

confidence: 99%

Implementation of a Nurse-Driven Burn Resuscitation Protocol: A Quality Improvement Project

Fahlstrom

Boyle

Makic

2013

Critical Care Nurse

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“…A large amount of fluid shifting to the third space is one of the most important factors responsible for IAH, and, therefore, the cumulative fluid load was examined to observe ACS in several studies. Friedrich et al 18 observed that burn patients tend to be administered fluid in excess of the Baxter formula, and they determined that large amounts of fluid contribute to abdominal and extreme compartment syndromes, as well as to pulmonary compliance. Corcos and Sherman 2 reported that three burned patients developed ACS after receiving 1.08 L/kg per 46-hour, 0.33 L/kg per 15-hour, and 0.47 L/kg per 29-hour infusion, whereas Hobson et al 8 reported that a mean of 237 mL/kg per 12-hour resuscitation fluid caused the development of ACS in their 10 patients.…”

Section: Discussionmentioning

confidence: 99%

Hypertonic Lactated Saline Resuscitation Reduces the Risk of Abdominal Compartment Syndrome in Severely Burned Patients

Oda

Ueyama

Yamashita

et al. 2006

The Journal of Trauma: Injury, Infection, and Critical Care

154

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“…The acknowledgement of "fluid creep" in crystalloid resuscitation and its subsequent effect on the evolution of the burn wound and systemic response are significant areas of clinical interest. 66 One potential conceptual focus could be on characterizing what differentiates burn injury from other proinflammatory stresses. Existing TSB global models of inflammation point to an effect of the degree of initial insult to the subsequent behavior of the system, 24,28,31,48,49 but perhaps there are particular aspects of the mechanism of burn injury that affect the systemic inflammatory response.…”

Section: Resuscitation Issuesmentioning

confidence: 99%

Translational Systems Biology: Introduction of an Engineering Approach to the Pathophysiology of the Burn Patient

Faeder

Vodovotz

2008

Journal of Burn Care & Research

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The pathophysiology of the burn patient manifests the full spectrum of the complexity of the inflammatory response. In the acute phase, inflammation may have negative effects via capillary leak, the propagation of inhalation injury, and development of multiple organ failure. Attempts to mediate these processes remain a central subject of burn care research. Conversely, inflammation is a necessary prologue and component in the later stage processes of wound healing. Despite the volume of information concerning the cellular and molecular processes involved in inflammation, there exists a significant gap between the knowledge of mechanistic pathophysiology and the development of effective clinical therapeutic regimens. Translational systems biology (TSB) is the application of dynamic mathematical modeling and certain engineering principles to biological systems to integrate mechanism with phenomenon and, importantly, to revise clinical practice. This study will review the existing applications of TSB in the areas of inflammation and wound healing, relate them to specific areas of interest to the burn community, and present an integrated framework that links TSB with traditional burn research. BURNS, BIOCOMPLEXITY, AND THE NEED FOR A TRANSLATIONAL METHODOLOGYThe burn community held its State of the Science meeting (Sponsored by the American Burn Association, the National Institutes of Health/National Institute of General Medical Sciences, the Shriners Hospitals for Children, the National Institute on Disability and Rehabilitation Research, the Department of Veterans Affairs and the U.S. Army Medical Materiel Command) from October 26-29, 2006, in order to determine the areas and foci of the community's research emphasis for the decade to come. These areas were defined primarily by their clinical manifestations or situations, such as resuscitation issues, inhalation injury, multiple organ failure, and wound healing. However, discussions invariably included references to the investigation of means by which known or suspected cellular and molecular pathophysiologic mechanisms could be translated into effective clinical treatments. These discussions included both the process of discovery for new

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Is supra-Baxter resuscitation in burn patients a new phenomenon?

Cited by 102 publications

References 13 publications

Implementation of a Nurse-Driven Burn Resuscitation Protocol: A Quality Improvement Project

Implementation of a Nurse-Driven Burn Resuscitation Protocol: A Quality Improvement Project

Hypertonic Lactated Saline Resuscitation Reduces the Risk of Abdominal Compartment Syndrome in Severely Burned Patients

Translational Systems Biology: Introduction of an Engineering Approach to the Pathophysiology of the Burn Patient

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