title: First resuscitation of critical burn patients: progresses and problems.
abstract: Currently, the aim of the resuscitation of burn patients is to maintain end-organ perfusion with fluid intake as minimal as possible. To avoid excess intake, we can improve the estimation using computer methods. Parkland and Brooke are the commonly used formulas, and recently, a new, an easy formula is been used, i.e. the 'Rule of TEN'. Fluid resuscitation should be titrated to maintain the urine output of approximately 30-35 mL/h for an average-sized adult. The most commonly used fluids are crystalloid, but the phenomenon of creep flow has renewed interest in albumin. In severely burn patients, monitoring with transpulmonary thermodilution together with lactate, ScvO2 and intraabdominal pressures is a good option. Nurse-driven protocols or computer-based resuscitation algorithms reduce the dependence on clinical decision making and decrease fluid resuscitation intake. High-dose vitamin C, propranolol, the avoidance of excessive use of morphine and mechanical ventilation are other useful resources.
authors.affiliation: Hospital Universitario La Paz/Carlos III, Instituto de Investigación IdiPaz, Madrid, Spain. Electronic address: manuelsanchezsa@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Sánchez-Sánchez
authors.affiliation: Hospital Universitario La Paz/Carlos III, Instituto de Investigación IdiPaz, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: García-de-Lorenzo
authors.affiliation: Hospital Universitario La Paz/Carlos III, Instituto de Investigación IdiPaz, Madrid, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Asensio
mesh_terms: D000418:Albumins; D002056:Burns / Q000628:therapy*; D005440:Fluid Therapy; D006801:Humans; D013815:Thermodilution
chemical_list: D000418:Albumins
keywords: Burn; Colloids; Coloides; Fluid resuscitation; Fluidos de resucitación; Quemados