| A prospective, randomized evaluation of intra-abdominal pressures with crystalloid and colloid resuscitation in burn patients. | |
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MedLine Citation:
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PMID: 15920417 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Michael S O'Mara; Harvey Slater; I William Goldfarb; Philip F Caushaj |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: The Journal of trauma Volume: 58 ISSN: 0022-5282 ISO Abbreviation: J Trauma Publication Date: 2005 May |
Date Detail:
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Created Date: 2005-05-27 Completed Date: 2005-06-28 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0376373 Medline TA: J Trauma Country: United States |
Other Details:
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Languages: eng Pagination: 1011-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Burns Surgery, Shriner's Hospital for Children of Northern California, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Abdomen
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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:
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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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