Document Detail


A prospective, randomized evaluation of intra-abdominal pressures with crystalloid and colloid resuscitation in burn patients.
MedLine Citation:
PMID:  15920417     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The volume of resuscitation in burn patients has been shown to correlate with intra-abdominal pressure (IAP). Limiting volume may reduce consequences of IAP and abdominal compartment syndrome. Colloid resuscitation has been previously shown to limit the volume required initially after burn. METHODS: Thirty-one patients were prospectively followed. Inclusion criteria were a burn of 25% total body surface area with inhalation injury or 40% total body surface area without. Patients received crystalloid (Parkland formula) or plasma resuscitation. IAP was measured by means of urinary bladder transduction. RESULTS: Mean age, area of burn, and baseline IAP were not different. Urine output was maintained. There was a greater increase in IAP with crystalloid (26.5 vs. 10.6 mmHg, p < 0.0001). Two patients in the plasma group developed IAP greater than 25 mmHg; only one patient in the crystalloid group maintained IAP less than 25 mmHg. More fluid volume was required with crystalloid resuscitation, 0.26 L/kg, versus 0.21 L/kg (p < 0.005). Correlation was seen in both groups between volume of fluid and IAP (crystalloid, r = 0.351; plasma, r = 0.657; all patients, r = 0.621). CONCLUSION: Plasma-resuscitated patients maintained an IAP below the threshold of complications of intra-abdominal hypertension. This appears to be a direct result of the decrease in volume required. Lower fluid volume regimens should be given consideration as the incidence and consequences of intra-abdominal hypertension in burn patients continue to be defined.
Authors:
Michael S O'Mara; Harvey Slater; I William Goldfarb; Philip F Caushaj
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of trauma     Volume:  58     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-05-27     Completed Date:  2005-06-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1011-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Burns Surgery, Shriner's Hospital for Children of Northern California, USA.
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MeSH Terms
Descriptor/Qualifier:
Abdomen / physiopathology*
Adult
Body Surface Area
Burns / physiopathology*,  therapy*
Colloids / therapeutic use
Humans
Isotonic Solutions
Middle Aged
Plasma*
Plasma Substitutes / therapeutic use*
Pressure
Prospective Studies
Resuscitation / methods*
Survival Analysis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Colloids; 0/Isotonic Solutions; 0/Plasma Substitutes; 0/crystalloid solutions

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


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