The use of a cardiac output monitor to guide the initial fluid resuscitation in a patient with burns.
A case of initial resuscitation of a patient with severe burns is described. Such patients can have hypotension and reduced organ perfusion for a number of reasons, and can remain in the emergency department for many hours while awaiting transfer to specialist centres. The case provides a comparison between resuscitation using traditional burns formulae and a relatively new and simple-to-use cardiac output (CO) monitor--the Vigileo monitor (Edwards Lifesciences, Irvine, California, USA). The case demonstrates that relying on fluid regimes alone can lead to insufficient resuscitation. We suggest that using technologies such as those mentioned in this article, which have the potential to be used in the emergency department, could improve the initial resuscitation of patients with burns.
Reid
Robert Darren
RD
Nottingham University Hospitals NHS Trust, Burton-On-Trent, Staffordshire, UK. darren_reid@hotmail.co.uk
Jayamaha
John
J
D000368:Aged; D002056:Burns / Q000150:complications* / Q000628:therapy*; D002303:Cardiac Output, Low / Q000175:diagnosis* / Q000209:etiology*; D004635:Emergency Medicine / Q000295:instrumentation / Q000379:methods; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006334:Heart Function Tests / Q000295:instrumentation; D006801:Humans; D007022:Hypotension / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome