title: Burn resuscitation.
abstract: Fluid resuscitation following burn injury must support organ perfusion with the least amount of fluid necessary and the least physiological cost. Under resuscitation may lead to organ failure and death. With adoption of weight and injury size-based formulas for resuscitation, multiple organ dysfunction and inadequate resuscitation have become uncommon. Instead, administration of fluid volumes well in excess of historic guidelines has been reported. A number of strategies including greater use of colloids and vasoactive drugs are now under investigation to optimize preservation of end organ function while avoiding complications which can include respiratory failure and compartment syndromes. Adjuncts to resuscitation, such as antioxidants, are also being investigated along with parameters beyond urine output and vital signs to identify endpoints of therapy. Here we briefly review the state-of-the-art and provide a sample of protocols now under investigation in North American burn centers.
authors.affiliation: The Burn Center, Regions Hospital, 640 Jackson Street, St, Paul, MN 55101, USA. frederick.w.endorf@healthpartners.com
authors.forename: Frederick W
authors.initials: FW
authors.lastname: Endorf
authors.forename: David J
authors.initials: DJ
authors.lastname: Dries
mesh_terms: D000465:Algorithms; D000975:Antioxidants / Q000627:therapeutic use; D002056:Burns / Q000503:physiopathology* / Q000628:therapy*; D002985:Clinical Protocols; D003102:Colloids / Q000627:therapeutic use; D005440:Fluid Therapy / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D006982:Hypertonic Solutions / Q000627:therapeutic use; D010956:Plasmapheresis; D012151:Resuscitation / Q000379:methods*; D013815:Thermodilution
chemical_list: D000975:Antioxidants; D003102:Colloids; D006982:Hypertonic Solutions
references.citation: Burns. 2007 Feb;33(1):25-30
references.pmid: 17223485
references.citation: J Trauma. 2009 Dec;67(6):1162-8
references.pmid: 20009662
references.citation: Burns. 2004 Sep;30(6):583-90
references.pmid: 15302427
references.citation: J Burn Care Res. 2011 Jan-Feb;32(1):110-7
references.pmid: 21131846
references.citation: J Burn Care Res. 2008 Jan-Feb;29(1):49-55
references.pmid: 18182897
references.citation: Arch Surg. 2000 Mar;135(3):326-31
references.pmid: 10722036
references.citation: Crit Care. 2011;15(2):R118
references.pmid: 21507260
references.citation: Burns. 2010 Nov;36(7):984-91
references.pmid: 20558004
references.citation: Burns. 2010 Mar;36(2):176-82
references.pmid: 20018451
references.citation: Crit Care. 2010;14(3):R123
references.pmid: 20584291
references.citation: J Burn Care Res. 2010 Jan-Feb;31(1):40-7
references.pmid: 20061836
references.citation: Ann N Y Acad Sci. 1968 Aug 14;150(3):874-94
references.pmid: 4973463
references.citation: Ann Surg. 1947 Dec;126(6):1010-45
references.pmid: 17859039
references.citation: J Burn Care Res. 2011 Jan-Feb;32(1):91-7
references.pmid: 21131844
references.citation: J Burn Care Res. 2007 Sep-Oct;28(5):708-14
references.pmid: 17667839
references.citation: Am J Emerg Med. 2009 Nov;27(9):1091-6
references.pmid: 19931756
references.citation: J Burn Care Res. 2010 Jul-Aug;31(4):551-8
references.pmid: 20616649
references.citation: J Burn Care Rehabil. 2000 Mar-Apr;21(2):91-5
references.pmid: 10752739
references.citation: Intensive Care Med. 2007 Jun;33(6):951-62
references.pmid: 17377769
references.citation: J Trauma. 2004 Feb;56(2):404-13; discussion 413-4
references.pmid: 14960986
references.citation: J Burn Care Res. 2010 Jan-Feb;31(1):48-56
references.pmid: 20061837
references.citation: J Burn Care Res. 2008 Jan-Feb;29(1):180-6
references.pmid: 18182919
references.citation: Crit Care Med. 2011 Sep;39(9):2031-8
references.pmid: 21532472
references.citation: J Burn Care Res. 2009 Mar-Apr;30(2):243-8
references.pmid: 19165108
references.citation: J Burn Care Res. 2007 Mar-Apr;28(2):231-40
references.pmid: 17351438
references.citation: J Trauma. 2000 Sep;49(3):567-8
references.pmid: 11003341
references.citation: Burns. 2004 Aug;30(5):464-6
references.pmid: 15225912
references.citation: J Burn Care Rehabil. 2002 Jan-Feb;23(1):21-6
references.pmid: 11803308
references.citation: J Trauma. 2006 Jan;60(1):64-71
references.pmid: 16456437
references.citation: J Burn Care Res. 2008 Jan-Feb;29(1):257-66
references.pmid: 18182930
references.citation: Burns. 2010 May;36(3):372-8
references.pmid: 19540673
references.citation: Intensive Care Med. 2006 Nov;32(11):1722-32
references.pmid: 16967294