The use of natural colloids in fluid resuscitation of severely burned patients


Authors: L. Fridrichová 1;  B. Lipový 1,2;  P. Brychta 1,2
Authors‘ workplace: Lékařská fakulta Masarykovy univerzity Brno 1;  Klinika popálenin a rekonstrukční chirurgie FN Brno 2
Published in: Transfuze Hematol. dnes,18, 2012, No. 4, p. 169-173.
Category: Comprehensive Reports, Original Papers, Case Reports

Overview

Objective:
The amount of natural colloids (albumin and fresh frozen plasma) administered during fluid resuscitation of burn patients is influenced by many factors. The most frequently cited include extent of the burned areas, presence of inhalation injury and age. The aim of our study was to determine whether these factors actually have such an influence on burn resuscitation, as expected.

Material and Methods:
The study included 75 patients treated at the Department for Burns and Reconstructive Surgery at the University Hospital in Brno from 2005 to 2010. We retrospectively investigated the amount of human albumin (HA) and fresh frozen plasma (FFP) during the 1st-7th and during the 8th and 14th day. Plasma concentrations of 60 g/L for total protein and 30 g/L for human albumin were set as the transfusion trigger values. Statistically, we evaluated whether more colloids, FFP and HA separately, were administered in patients with inhalation trauma, in patients over 50 years and in patients with a greater extent of burns. We then divided the patients into four groups according to the extent of burned areas and assessed the data within each group.

Results:
Extent of the burned areas proved to be statistically highly significant. This manifested especially as a difference between the groups with burns extending up to 50% (in patients up to 10%, 30% and 50% burned areas). The difference between patients with burns extending from 30 to 50%, and patients with burns extending over 50% was not statistically significant. The effect of the presence of inhalation injury was shown to be somewhat controversial. When evaluating its impact regardless of the extent of the burned areas, the difference between the amount administered to patients with inhalation injury and to those without was statistically very significant. However, the same did not apply when it was evaluated in the different groups. Age did not have any effect on the amount of natural colloids administered.

Conclusion:
While the study showed a significant effect of the extent of burned areas on the amount of natural colloids administered during the first 14 days after the burn, the effect of the presence of inhalation trauma remains controversial. The effect of age was not demonstrated.

Key words:
burns, fluid resuscitation, natural colloids, inhalation injury, extent of burned areas


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Labels
Haematology Internal medicine Clinical oncology
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