﻿﻿﻿﻿﻿﻿From cholera to "fluid creep": a historical review of fluid resuscitation of the burn trauma patient.
﻿Resuscitation of the burn trauma patient presents unique dynamic challenges, which often involve the critical care management of multiple physiological derangements. It is well known that a major burn injury can lead to burn shock and involve multiple organ systems. Fluid resuscitation is the mainstay in prevention of burn shock and for initial stabilization. To date, many studies have focused on the importance of fluid resuscitation in the treatment of burn patients; however, there is no one universally accepted model for intravenous fluid therapy. Certainly, monumental advances have been made in burn resuscitation, which have lead to dramatically decreased mortality rates and virtually eliminated post-burn renal failure. The early work of Cope and Moore, Evans, Artz, Moyer, Baxter, Pruitt, and others have served us well and continue to drive modern fluid resuscitation. Which formula is most appropriate and which fluid, or combination of fluids, is most advantageous continues to be debated today. Regardless of which formula is used, it is clear that continuous individual titration of volume must be made according to the patients clinical response to avoid the detrimental problems associated with both over resuscitation and under resuscitation.
Saint Elizabeth Regional Burn and Wound Care Center, Lincoln, NE; Email: seanlhansen@hotmail.com.
Sean L
SL
Hansen