Fluid resuscitation management in patients with burns: Update

P. Guilabert*, G. Usúa, N. Martín, L. Abarca, J. P. Barret, M. J. Colomina

*Corresponding author for this work

Research output: Contribution to journalReview articleResearchpeer-review

28 Citations (Scopus)

Abstract

Since 1968, when Baxter and Shires developed the Parkland formula, little progress has been made in the field of fluid therapy for burn resuscitation, despite advances in haemodynamic monitoring, establishment of the 'goal-directed therapy' concept, and the development of new colloid and crystalloid solutions. Burn patients receive a larger amount of fluids in the first hours than any other trauma patients. Initial resuscitation is based on crystalloids because of the increased capillary permeability occurring during the first 24 h. After that time, some colloids, but not all, are accepted. Since the emergence of the Pharmacovigilance Risk Assessment Committee alert from the European Medicines Agency concerning hydroxyethyl starches, solutions containing this component are not recommended for burns. But the question is: what do we really know about fluid resuscitation in burns? To provide an answer, we carried out a non-systematic review to clarify how to quantify the amount of fluids needed, what the current evidence says about the available solutions, and which solution is the most appropriate for burn patients based on the available knowledge.

Original languageAmerican English
Pages (from-to)284-296
Number of pages13
JournalBritish Journal of Anaesthesia
Volume117
Issue number3
DOIs
Publication statusPublished - 1 Sep 2016

Keywords

  • burns
  • colloids
  • crystalloid solutions
  • fluid therapy
  • thermodilution

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