Document Detail


The comparison of early fluid therapy in extensive flame burns between inhalation and noninhalation injuries.
MedLine Citation:
PMID:  9882069     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Over the last half century, advances in treatment have changed the principal cause of death in burn patients from burn shock and wound sepsis to pulmonary sepsis, of which inhalation injury has always played a key role in morbidity and mortality. Even though Navar et al., Am. J. Surg. 1985;150:716-720 have noted that patients with inhalation injury had a mean fluid requirement of 5.8 ml/kg/% burn to achieve resuscitation from early burn shock, while patients without inhalation injury required only a mean fluid of 4.0 ml/kg/% burn, to achieve successful resuscitation in inhalation injured patients with minimum but adequate fluid has always been a challenge. To further define the difference of early fluid therapy between inhalation and noninhalation in extensively burned patients, a retrospective analysis was carried out in the Tri-Service General Hospital. Sixty-two flame burned patients (aged from 16 to 81 years-old with a mean age of 33.2+/-15.1 years: with burn size ranging from 30% to 98% TBSA with a mean burn size of 60.5+/-22.7%; 26 with inhalation injury; noninhalation 36) were reviewed during a 5-year period. The Parkland formula is the initial choice of fluid regimen with 4 ml/kg/% burn and the amount of replacement is monitored by urine output and is titrated to maintain urine output between 0.5 and 1.0 ml/kg/h. The mean amounts of fluid requirements of both inhalation and noninhalation burned patients were 3.1 +/- 1.0 and 2.3+/-0.8 ml/kg/% burn respectively (p < 0.05). Our study showed less fluid requirement for both inhalation and noninhalation injured patients in comparison with the Navar study and Parkland predictions in the first 24 h postburn. Furthermore, the inhalation injured patients definitely required volumes of fluid in excess of those required in noninhalation injured cases.
Authors:
N T Dai; T M Chen; T Y Cheng; S L Chen; S G Chen; G H Chou; T D Chou; H J Wang
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Burns : journal of the International Society for Burn Injuries     Volume:  24     ISSN:  0305-4179     ISO Abbreviation:  Burns     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1999-03-16     Completed Date:  1999-03-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8913178     Medline TA:  Burns     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  671-5     Citation Subset:  IM    
Affiliation:
Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Burns / diagnosis,  etiology,  therapy*
Burns, Inhalation / diagnosis,  etiology,  therapy
Facial Injuries / diagnosis,  etiology,  therapy
Fires
Fluid Therapy*
Humans
Infusions, Intravenous
Isotonic Solutions / administration & dosage,  therapeutic use*
Middle Aged
Rehydration Solutions / administration & dosage,  therapeutic use*
Resuscitation / methods
Retrospective Studies
Trauma Severity Indices
Treatment Outcome
Chemical
Reg. No./Substance:
0/Isotonic Solutions; 0/Rehydration Solutions; 8026-10-6/Ringer's solution

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


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