Fluid requirements of patients with burns and inhalation injuries in an intensive care unit.
We have studied 9 patients with burns (20%-75%) who had inhalation injuries and compared their actual fluid requirements with their requirements calculated from the Muir and Barclay formula. All patients were resuscitated with plasma protein fraction at a rate sufficient to keep their physiological variables within the following range: heart rate less than 120/min, central venous pressure 8-12 cm H2O, urine output greater than 30-50 ml/h, systolic blood pressure greater than 90 mm Hg and diastolic blood pressure greater than 60 mm Hg. The amount of plasma protein fraction needed was 4.38 +/- 1.26 ml/kg/% burn in the first 24 h and 2.15 +/- 0.97 ml/kg/% burn in the second 24 h. This is an increase of 75% and 110% respectively above values predicted from the formula. We suggest that the observed difference is due to a combination of the presence of an inhalation injury which increases fluid requirements by approximately 30% in the first 24 h and the use of plasma protein fraction rather than the dried plasma used in the original Muir and Barclay formula.
Hughes
K R
KR
Intensive Care Unit, University College Hospital, London, UK.
Armstrong
R F
RF
Brough
M D
MD
Parkhouse
N
N
D000328:Adult; D001798:Blood Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D001835:Body Weight; D002056:Burns / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D002059:Burns, Inhalation / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D003422:Critical Care; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012151:Resuscitation
D001798:Blood Proteins