Document Detail

Hemodynamic changes during resuscitation after burns using the Parkland formula.
MedLine Citation:
PMID:  19204504     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The Parkland formula (2-4 mL/kg/burned area of total body surface area %) with urine output and mean arterial pressure (MAP) as endpoints for the fluid resuscitation in burns is recommended all over the world. There has recently been a discussion on whether central circulatory endpoints should be used instead, and also whether volumes of fluid should be larger. Despite this, there are few central hemodynamic data available in the literature about the results when the formula is used correctly. METHODS: Ten burned patients, admitted to our unit early, and with a burned area of >20% of total body surface area were investigated at 12, 24, and 36 hours after injury. Using transesophageal echocardiography, pulmonary artery catheterization, and transpulmonary thermodilution to monitor them, we evaluated the cardiovascular coupling when urinary output and MAP were used as endpoints. RESULTS: Oxygen transport variables, heart rate, MAP, and left ventricular fractional area, did not change significantly during fluid resuscitation. Left ventricular end-systolic and end-diastolic area and global end-diastolic volume index increased from subnormal values at 12 hours to normal ranges at 24 hours after the burn. Extravascular lung water: intrathoracal blood volume ratio was increased 12 hours after the burn. CONCLUSIONS: Preload variables, global systolic function, and oxygen transport recorded simultaneously by three separate methods showed no need to increase the total fluid volume within 36 hours of a major burn. Early (12 hours) signs of central circulatory hypovolemia, however, support more rapid infusion of fluid at the beginning of treatment.
Zoltan Bak; Folke Sjöberg; Olle Eriksson; Ingrid Steinvall; Birgitta Janerot-Sjoberg
Related Documents :
3004184 - Relative contribution of inotropic and vasodilator effects to amrinone-induced hemodyna...
18227354 - Chronic cardiac resynchronization therapy reverses cardiac remodelling and improves inv...
1954074 - Effects of atropine on left ventricular volumes and ejection and filling rates at rest ...
10347384 - Right heart volumetric monitoring: measuring preload in the critically injured patient.
3310664 - Arterial pressure after chronic reductions in suprarenal aortic flow in fetal lambs.
22219234 - Overcoming barriers to hypertension control in african americans.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of trauma     Volume:  66     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-10     Completed Date:  2009-04-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  329-36     Citation Subset:  AIM; IM    
Department of Intensive Care, Heart Centre, Linköping University Hospital, Linköping, Sweden.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Aged, 80 and over
Analysis of Variance
Body Surface Area
Burns / physiopathology*,  therapy*
Catheterization, Swan-Ganz
Echocardiography, Transesophageal
Fluid Therapy / methods*
Intermittent Positive-Pressure Ventilation
Middle Aged
Oxygen Consumption
Resuscitation / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Comparison of new hemostatic granules/powders with currently deployed hemostatic products in a letha...
Next Document:  Microcirculatory parameters after isotonic and hypertonic colloidal fluid resuscitation in acute hem...