title: Fluid resuscitation management in patients with burns: update.
abstract: Since 1968, when Baxter and Shires developed the Parkland formula, little progress has been made in the field of fluid therapy for burn resuscitation, despite advances in haemodynamic monitoring, establishment of the 'goal-directed therapy' concept, and the development of new colloid and crystalloid solutions. Burn patients receive a larger amount of fluids in the first hours than any other trauma patients. Initial resuscitation is based on crystalloids because of the increased capillary permeability occurring during the first 24 h. After that time, some colloids, but not all, are accepted. Since the emergence of the Pharmacovigilance Risk Assessment Committee alert from the European Medicines Agency concerning hydroxyethyl starches, solutions containing this component are not recommended for burns. But the question is: what do we really know about fluid resuscitation in burns? To provide an answer, we carried out a non-systematic review to clarify how to quantify the amount of fluids needed, what the current evidence says about the available solutions, and which solution is the most appropriate for burn patients based on the available knowledge.
authors.affiliation: Anesthesia and Critical Care Department patricia.guilabert@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Guilabert
authors.affiliation: Anesthesia and Critical Care Department.
authors.forename: G
authors.initials: G
authors.lastname: Usúa
authors.affiliation: Anesthesia and Critical Care Department.
authors.forename: N
authors.initials: N
authors.lastname: Martín
authors.affiliation: Anesthesia and Critical Care Department.
authors.forename: L
authors.initials: L
authors.lastname: Abarca
authors.affiliation: Plastic Surgery Department and Burn Centre, Hospital Universitari Vall d'Hebron, Barcelona 08035, Spain.
authors.forename: J P
authors.initials: JP
authors.lastname: Barret
authors.affiliation: Anesthesia and Critical Care Department.
authors.forename: M J
authors.initials: MJ
authors.lastname: Colomina
mesh_terms: D002056:Burns / Q000628:therapy*; D003102:Colloids / Q000627:therapeutic use; D000077324:Crystalloid Solutions; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007552:Isotonic Solutions / Q000627:therapeutic use
chemical_list: D003102:Colloids; D000077324:Crystalloid Solutions; D007552:Isotonic Solutions
keywords: burns; colloids; crystalloid solutions; fluid therapy; thermodilution