open access

Vol 47 (2015): Special issue
Review articles
Published online: 2015-10-20
Submitted: 2015-09-05
Accepted: 2015-10-03
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An overview on fluid resuscitation and resuscitation endpoints in burns: Past, present and future. Part 1 — historical background, resuscitation fluid and adjunctive treatment

Yannick Peeters, Stefanie Vandervelden, Robert Wise, Manu L.N.G. Malbrain
DOI: 10.5603/AIT.a2015.0063

open access

Vol 47 (2015): Special issue
Review articles
Published online: 2015-10-20
Submitted: 2015-09-05
Accepted: 2015-10-03

Abstract

An improved understanding of burn shock pathophysiology and subsequent development of fluid resuscitation strategies has led to dramatic outcome improvements in burn care during the 20th century. While organ hypoperfusion caused by inadequate resuscitation has become rare in clinical practice, there is growing concern that increased morbidity and mortality related to over-resuscitation is occurring more frequently in burn care. In order to reduce complications related to this concept of “fluid creep”, such as respiratory failure and compartment syndromes, efforts should be made to resuscitate with the least amount of fluid in order to provide adequate organ perfusion. In this first part of a concise review, historic and current evidence regarding the available fluids is discussed, as well as some adjunctive treatments modulating the inflammatory response. In the second part, special reference will be made to the role of abdominal hypertension in burn care and the endpoints used to guide fluid resuscitation will be discussed. Finally, as urine output has been recognized as a poor resuscitation target, a resuscitation protocol is suggested in part two which includes new targets and endpoints that can be obtained with modern, less invasive hemodynamic monitoring devices.

Abstract

An improved understanding of burn shock pathophysiology and subsequent development of fluid resuscitation strategies has led to dramatic outcome improvements in burn care during the 20th century. While organ hypoperfusion caused by inadequate resuscitation has become rare in clinical practice, there is growing concern that increased morbidity and mortality related to over-resuscitation is occurring more frequently in burn care. In order to reduce complications related to this concept of “fluid creep”, such as respiratory failure and compartment syndromes, efforts should be made to resuscitate with the least amount of fluid in order to provide adequate organ perfusion. In this first part of a concise review, historic and current evidence regarding the available fluids is discussed, as well as some adjunctive treatments modulating the inflammatory response. In the second part, special reference will be made to the role of abdominal hypertension in burn care and the endpoints used to guide fluid resuscitation will be discussed. Finally, as urine output has been recognized as a poor resuscitation target, a resuscitation protocol is suggested in part two which includes new targets and endpoints that can be obtained with modern, less invasive hemodynamic monitoring devices.

Get Citation

Keywords

burns, fluid resuscitation, treatment, resuscitation endpoint/target, crystalloid, colloid, albumin, adjunctive treatments

About this article
Title

An overview on fluid resuscitation and resuscitation endpoints in burns: Past, present and future. Part 1 — historical background, resuscitation fluid and adjunctive treatment

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 47 (2015): Special issue

Pages

6-14

Published online

2015-10-20

DOI

10.5603/AIT.a2015.0063

Keywords

burns
fluid resuscitation
treatment
resuscitation endpoint/target
crystalloid
colloid
albumin
adjunctive treatments

Authors

Yannick Peeters
Stefanie Vandervelden
Robert Wise
Manu L.N.G. Malbrain

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