Sánchez-Sánchez M, García-de-Lorenzo A, Asensio MJ, et al.
Medicina intensiva. Date of publication 2016 Mar 1;volume 40(2):118-24.
1. Med Intensiva. 2016 Mar;40(2):118-24. doi: 10.1016/j.medin.2015.12.001. Epub 2016
Feb 9.
First resuscitation of critical burn patients: progresses and problems.
[Article in English, Spanish]
Sánchez-Sánchez M(1), García-de-Lorenzo A(2), Asensio MJ(2).
Author information:
(1)Hospital Universitario La Paz/Carlos III, Instituto de Investigación IdiPaz,
Madrid, Spain. Electronic address: manuelsanchezsa@gmail.com.
(2)Hospital Universitario La Paz/Carlos III, Instituto de Investigación IdiPaz,
Madrid, Spain.
Currently, the aim of the resuscitation of burn patients is to maintain end-organ
perfusion with fluid intake as minimal as possible. To avoid excess intake, we
can improve the estimation using computer methods. Parkland and Brooke are the
commonly used formulas, and recently, a new, an easy formula is been used, i.e.
the 'Rule of TEN'. Fluid resuscitation should be titrated to maintain the urine
output of approximately 30-35 mL/h for an average-sized adult. The most commonly
used fluids are crystalloid, but the phenomenon of creep flow has renewed
interest in albumin. In severely burn patients, monitoring with transpulmonary
thermodilution together with lactate, ScvO2 and intraabdominal pressures is a
good option. Nurse-driven protocols or computer-based resuscitation algorithms
reduce the dependence on clinical decision making and decrease fluid
resuscitation intake. High-dose vitamin C, propranolol, the avoidance of
excessive use of morphine and mechanical ventilation are other useful resources.
Copyright © 2016 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.
DOI: 10.1016/j.medin.2015.12.001
PMID: 26873418 [Indexed for MEDLINE]
