Protocolized Resuscitation of Burn Patients.
Fluid resuscitation of burn patients is commonly initiated using modified Brooke or Parkland formula. The fluid infusion rate is titrated up or down hourly to maintain adequate urine output and other endpoints. Over-resuscitation leads to morbid complications. Adherence to paper-based protocols, flow sheets, and clinical practice guidelines is associated with decreased fluid resuscitation volumes and complications. Computerized tools assist providers. Although completely autonomous closed-loop control of resuscitation has been demonstrated in animal models of burn shock, the major advantages of open-loop and decision-support systems are identifying trends, enhancing situational awareness, and encouraging burn team communication.
US Army Institute of Surgical Research, 3698 Chambers Pass, JBSA Fort Sam Houston, TX 78234-6315, USA. Electronic address: leopoldo.c.cancio.civ@mail.mil.
Leopoldo C
LC
Cancio
US Army Institute of Surgical Research, 3698 Chambers Pass, JBSA Fort Sam Houston, TX 78234-6315, USA.
Jose
J
Salinas
Department of Anesthesiology, University of Texas Medical Branch at Galveston, Galveston, TX 77555-1102, USA.
George C
GC
Kramer
D000465:Algorithms; D002056:Burns / Q000503:physiopathology / Q000628:therapy*; D002985:Clinical Protocols; D003661:Decision Support Techniques; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D012151:Resuscitation / Q000379:methods*; D013813:Therapy, Computer-Assisted; D014556:Urine
Burns; Decision making—Computer-Assisted; Decision support systems - Clinical; Fluid resuscitation