title: Safety of resuscitation with Ringer's acetate solution in severe burn (VolTRAB)--an observational trial.
abstract: BACKGROUND
  A variety of crystalloids are available during fluid resuscitation of the severely burnt patient. There is a paucity of literature evidence on the comparative influence of these with regard to clinical outcomes. Significant differences in crystalloids may be clinically relevant given the large volumes employed during shock resuscitation.
  
  
  METHODS
  The study compared two groups of severely burnt patients (TBSA 20-70%). Prospectively 40 consecutive patients treated with Ringer's acetate (RA group) against a retrospective control group of 40 patients treated with Ringer's lactate (RL group). Outcome parameters analysed included Sequential Organ Failure Assessment (SOFA)-scores at Days 3 and 7 after injury, mortality at 28 and 60 days, electrolyte and renal function, infection rates, cumulative volume administration and duration of ventilator support.
  
  
  RESULTS
  Groups RA and RL were comparable w.r.t. age, total body surface area burn size and ABSI. SOFA-scores on Day 1 of admission also showed no significant difference but were significantly lower in RA group between the 3rd and 6th day. By Day 7 these differences could be attributed as a group effect (P=0.019). In particular low cardiovascular organ function scores contributed to this. Total crystalloid use within the first 28 days were equal in both but differed within the RA group having lower observed volumes of colloid and incidence of blood transfusion. Furthermore group RA had distinctly higher levels of platelets throughout treatment. Elevated lactate levels were noted in RL group during the initial three days. Survival rates at 28 days and 60 days showed no significant difference.
  
  
  CONCLUSIONS
  Ringer's acetate solution is a suitable medium for the initial fluid management of the acutely burnt patient. In comparison to Ringer's lactate solution the study revealed lower SOFA-scores for Ringer's acetate solution (ClinicalTrials.gov number, NCT00609700).
authors.affiliation: Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, St. Georg Hospital GmbH Leipzig, Germany. Electronic address: Jochen.Gille@sanktgeorg.de.
authors.forename: Jochen
authors.initials: J
authors.lastname: Gille
authors.affiliation: Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, St. Georg Hospital GmbH Leipzig, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Klezcewski
authors.affiliation: Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, St. Georg Hospital GmbH Leipzig, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Malcharek
authors.affiliation: Department of Plastic and Handsurgery, St. Georg Hospital GmbH Leipzig, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Raff
authors.affiliation: MoReData GmbH, Kerkrader Str. 11, 35394 Gießen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Mogk
authors.affiliation: Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, St. Georg Hospital GmbH Leipzig, Germany.
authors.forename: Armin
authors.initials: A
authors.lastname: Sablotzki
authors.affiliation: Department of Plastic & Reconstructive Surgery, Royal Devon & Exeter Hospital Foundation Trust, Exeter, Devon, UK.
authors.forename: Hischam
authors.initials: H
authors.lastname: Taha
mesh_terms: D000328:Adult; D000368:Aged; D002056:Burns / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007552:Isotonic Solutions / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000077325:Ringer's Lactate; D016896:Treatment Outcome
chemical_list: D007552:Isotonic Solutions; D000077325:Ringer's Lactate; C028570:Ringer's acetate
keywords: Burn resuscitation; Ringer's acetate; Ringer's lactate; SOFA score