The evolution of burn fluid resuscitation

Diver, Andrew J.

doi:10.1016/j.ijsu.2008.02.003

Cited by 19 publications

(14 citation statements)

References 16 publications

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“…The fluid infusion to the patient was adjusted to achieve an hourly urine output of 0.5–1.0 mL/kg/h and mean arterial pressure values greater than 70 mmHg. 9 , 10 , 11 A fall in the parameters was adjusted with bolus dose of crystalloid infusion. An hourly critical care flow chart was used to determine the actual crystalloid resuscitation volume received by the patient, the hourly urine output over the first 24 h, the central venous pressure and the mean arterial blood pressure (MAP) recorded for each hour during fluid resuscitation.…”

Section: Methodsmentioning

confidence: 99%

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Effectiveness of Parkland formula in the estimation of resuscitation fluid volume in adult thermal burns

Ete

Chaturvedi

Barreto

et al. 2019

Chinese Journal of Traumatology

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Purpose Acute burn resuscitation in initial 24 h remains a challenge to plastic surgeons. Though various formulae for fluid infusion are available but consensus is still lacking, resulting in under resuscitation or over resuscitation. Parkland formula is widely used but recently its adequacy is questioned in studies. This study was conducted to see how closely the actual volume of fluid given in our center matches with that of calculated volume by Parkland formula. Methods All patients admitted with more than 20% flame burn injury and within 8 h of incident were included in this study. Crystalloid solution for infusion was calculated as per Parkland formula; however, it was titrated according to the urine output. Data on fluid infusion were collected from patient's inpatient records and analyzed. Results The study included a total of 90 patients, about 86.7% ( n = 78) of the patients received fluid less than the calculated Parkland formula. Rate of fluid administered over 24 h in our study was 3.149 mL/kg/h. Mean hourly urine output was found to be 0.993 mL/kg/h. The mean difference between fluid administered and fluid calculated by Parkland formula was 3431.825 mL which was significant ( p < 0.001). Conclusion The study showed a significant difference in the fluid infused based on urine output and the fluid calculated by Parkland formula. This probably is because fluid infused based on end point of resuscitation was more physiological than fluid calculated based on formulae.

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Section: Methodsmentioning

confidence: 99%

“…The fluid infusion to the patient was adjusted to achieve an hourly urine output of 0.5–1.0 mL/kg/h and mean arterial pressure values greater than 70 mmHg 9, 10, 11. A fall in the parameters was adjusted with bolus dose of crystalloid infusion.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of Parkland formula in the estimation of resuscitation fluid volume in adult thermal burns

Ete

Chaturvedi

Barreto

et al. 2019

Chinese Journal of Traumatology

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“…A significant body of research regarding modern fluid resuscitation protocols Burn Shock and Resuscitation: Many Priorities, One Goal DOI: http://dx.doi.org /10.5772/intechopen.85646 demonstrates that systemic capillary leakage during the initial 24-h period after injury permits movement of large molecules into the interstitial space [92,93]. For this reason, colloids are generally considered to provide little added benefit to crystalloid administration in the first 24 h. The topic is somewhat controversial, however, as some researchers argue that capillary permeability may begin returning to normal as early as 6-8 h after injury [90,94,95]. Consequently, the latter group advocates that earlier colloid addition may reduce the total amount of fluid necessary to achieve hemodynamic resuscitation and intravascular volume restoration.…”

Section: Burn Shockmentioning

confidence: 99%

Burn Shock and Resuscitation: Many Priorities, One Goal

Sojka¹,

Krakowski²,

Stawicki³

2020

Clinical Management of Shock - The Science and Art of Physiological Restoration

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Burn injuries come in a wide variety of presentations, depending on the size and depth of the thermal insult, concurrent traumatic or inhalation injury, as well as the associated physiological response of the burn victim. To minimize patient morbidity and reduce mortality, prompt recognition and tailored treatment strategies are critically important. As the percentage of total body surface area (TBSA) burned increases so do the body's physiologic response and the associated complexity of management. Understanding the pathophysiology of burn injury allows the practitioner to optimize and individualize burn patient management-a component of care critical to limiting wound progression and improving outcomes. Burn patient care starts with an accurate and thorough burn patient evaluation conducted in person by an experienced provider. For burns >10-15% TBSA, prompt initiation of fluid resuscitation greatly impacts clinical outcomes. Several formulae have been published to guide crystalloid and/or colloid fluid resuscitation in the setting of burn shock. Other important considerations include ambient temperature control, early enteral nutritional support, vitamin and mineral supplementation, assessment for inhalation injury, glycemic control, early recognition of potential complications of large volume resuscitation, potential need for cardiovascular support, and early wound excision and coverage. Burn patients often require multidisciplinary teams to manage the physical, social, and psychological effects associated with their injury. Dedicated burn centers are the ideal places for meeting the complex needs of each burn patient.

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“…Loss of the skin's normal protective barrier results in a number of consequences including significant fluid loss. The normal homeostatic functions of skin are disrupted, causing loss of temperature regulation and the ability to maintain BP by vasoconstriction 2. Inadequate resuscitation results in a deepening of burn injury and the need for more aggressive surgery, and may result in acute renal failure with an associated increase in mortality.…”

Section: Introductionmentioning

confidence: 99%