| The association between fluid administration and outcome following major burn: a multicenter study. | |
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MedLine Citation:
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PMID: 17414612 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine patient and injury variables that influence fluid requirements following burn injury and examine the association between fluid volume received and outcome. BACKGROUND: Fluid resuscitation remains the cornerstone of acute burn management. Recent studies suggest that patients today are receiving more fluid per percent total body surface area (TBSA) than in the past. Therefore, there is a need to better define the factors that impact fluid requirements and to determine the effects of fluid volumes on outcome. METHODS: This study was part of a federally funded multicenter study. Multilinear regression analyses were performed to determine the patient and injury characteristics that most influenced fluid resuscitation volumes received. To assess the association of fluid volumes on outcome, propensity scores were developed to provide a predicted volume of fluid for each patient. Logistic models were then used to assess the impact of excess fluid beyond predicted volumes on outcome. RESULTS: Seventy-two patients were included in this analysis. Average patient age was 40.6 years and average TBSA was 44.5%. Average fluid volume received during the first 24 hours after injury was 5.2/mL/kg/TBSA. Significant predictors of fluid received included % TBSA, age, intubation status, and weight. Increased fluid volume received increased risk of development of pneumonia (odds ratio [OR] = 1.92), bloodstream infections (OR =2.33), adult respiratory distress syndrome (OR = 1.55), multiorgan failure (OR= 1.49), and death (OR = 1.74). CONCLUSION: TBSA, age, weight, and intubation status on admission were significant predictors of fluid received. Patients who received larger volumes of resuscitation fluid were at higher risk for injury complications and death. |
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Authors:
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Matthew B Klein; Douglas Hayden; Constance Elson; Avery B Nathens; Richard L Gamelli; Nicole S Gibran; David N Herndon; Brett Arnoldo; Geoff Silver; David Schoenfeld; Ronald G Tompkins |
Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Annals of surgery Volume: 245 ISSN: 0003-4932 ISO Abbreviation: Ann. Surg. Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-04-06 Completed Date: 2007-05-29 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 0372354 Medline TA: Ann Surg Country: United States |
Other Details:
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Languages: eng Pagination: 622-8 Citation Subset: AIM; IM |
Affiliation:
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University of Washington Burn Center, Harborview, Medical Center, University of Washington, Seattle, WA 98121, USA. mbklein@u.washington.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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APACHE Adolescent Adult Aged Aged, 80 and over Burns / blood, complications, therapy* Female Fluid Therapy* Humans Logistic Models Male Middle Aged Multiple Organ Failure / blood, etiology Retrospective Studies Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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K12 HD049100/HD/NICHD NIH HHS; U54 GM062119-1/GM/NIGMS NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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