Adequate resuscitation of burn patients may not be measured by urine output and vital signs.
OBJECTIVE
To compare vital sign and urine output monitoring of seriously burned patients with invasive monitoring during early resuscitation.


METHODS
Retrospective review.


METHODS
A university hospital burn unit.


METHODS
Fourteen seriously burned patients who had pulmonary arterial monitoring. Monitoring data were compared at baseline and after fluid challenges.


RESULTS
There was no correlation between invasively derived physiologic variables and vital signs and urine output. Vital signs and urine output changed little after fluid challenge, while variables from invasive monitoring demonstrated significant change. In half of the patients, oxygen consumption increased after fluid challenge; vital signs and urine output did not distinguish these patients.


CONCLUSIONS
The use of urinary output and vital signs to guide initial burn resuscitation may lead to suboptimal resuscitation. Invasive cardiorespiratory monitoring may be necessary to optimize resuscitation of seriously burned patients.
Dries
D J
DJ
Department of Surgery, Loyola University Medical Center, Maywood, IL.
Waxman
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D002053:Burn Units; D002056:Burns / Q000628:therapy* / Q000652:urine; D002648:Child; D003422:Critical Care; D005260:Female; D005440:Fluid Therapy; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D012151:Resuscitation / Q000379:methods*; D012189:Retrospective Studies