| Decreased fluid volume to reduce organ damage: a new approach to burn shock resuscitation? A preliminary study. | |
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MedLine Citation:
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PMID: 17137702 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the impact of decreased fluid resuscitation on multiple-organ dysfunction after severe burns. This approach was referred to as "permissive hypovolaemia". METHODS: Two cohorts of patients with burns>20% BSA without associated injuries and admitted to ICU within 6 h from the thermal injury were compared. Patients were matched for both age and burn severity. The multiple-organ dysfunction score (MODS) by Marshall was calculated for 10 days after ICU admission. Permissive hypovolaemia was administered by a haemodynamic-oriented approach throughout the first 24-h period. Haemodynamic variables, arterial blood lactates and net fluid balance were obtained throughout the first 48 h. RESULTS: Twenty-four patients were enrolled: twelve of them received the Parkland Formula while twelve were resuscitated according to the permissive hypovolaemic approach. Permissive hypovolaemia allowed for less volume infusion (3.2+/-0.7 ml/kg/% burn versus 4.6+/-0.3 ml/kg/% burn; P<0.001), a reduced positive fluid balance (+7.5+/-5.4 l/day versus +12+/-4.7 l/day; P<0.05) and significantly lesser MODS Score values (P=0.003) than the Parkland Formula. Both haemodynamic variables and arterial blood lactate levels were comparable between the patient cohorts throughout the resuscitation period. CONCLUSIONS: Permissive hypovolaemia seems safe and well tolerated by burn patients. Moreover, it seems effective in reducing multiple-organ dysfunction as induced by oedema fluid accumulation and inadequate O2 tissue utilization. |
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Authors:
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S Arlati; E Storti; V Pradella; L Bucci; A Vitolo; M Pulici |
Publication Detail:
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Type: Journal Article Date: 2006-11-29 |
Journal Detail:
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Title: Resuscitation Volume: 72 ISSN: 0300-9572 ISO Abbreviation: Resuscitation Publication Date: 2007 Mar |
Date Detail:
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Created Date: 2007-02-19 Completed Date: 2007-04-26 Revised Date: 2009-08-25 |
Medline Journal Info:
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Nlm Unique ID: 0332173 Medline TA: Resuscitation Country: Ireland |
Other Details:
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Languages: eng Pagination: 371-8 Citation Subset: IM |
Affiliation:
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Intensive Care Unit G. Bozza, Niguarda Cà-Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy. sergioarlati@yahoo.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Body Fluids / metabolism* Burn Units Burns / complications, metabolism, therapy* Female Fluid Therapy / methods* Follow-Up Studies Humans Hypovolemia / metabolism* Lactates / blood Male Middle Aged Resuscitation / methods* Retrospective Studies Shock, Traumatic / etiology, metabolism, therapy* Trauma Severity Indices Treatment Outcome Vascular Resistance / physiology |
| Chemical | |
Reg. No./Substance:
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0/Lactates |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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