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A comparison of two different fluid resuscitation management protocols for pediatric burn patients: A retrospective study
Authors:Miao Huang  Jun-Feng Chen  Li-ying Chen  Li-qin Pan  Xiao-jian Li  Jie-yu Ye  Hui-yi Tan
Affiliation:1. Department of Nursing, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Jinan University, Guangzhou, 510220, China;2. Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Ministry of Education, Guangzhou, 510630, China;3. Department of Burns, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Jinan University, Guangzhou, 510220, China
Abstract:

Objective

Pediatric burn patients are more susceptible to burn shock than adults, and an effective fluid management protocol is critical to successful resuscitation. Our research aim was to investigate the safety and efficacy of two protocols for pediatric burn patients for use within the first 24 h.

Methods

A total of 113 pediatric burn patients were enrolled from January 2007 to October 2012. Of those patients, 57 received fluid titration regimens of alternating crystalloids and colloids once within 2 h in the first 24 h after burn (Group A), whereas the remaining patients received regimens of alternating crystalloids and colloids once within 1 h in the first 24 h after burn (Group B). The safety, fluid volume infused and urine output were recorded and compared.

Results

All the patients survived in the first 24 h after burn. There were no significant differences between Group A and Group B in lactic acid (LA) level and base excess (BE). The water infused in Group A were greater than that of Group B in the first 24 h (P = 0.024). No significant differences were found in total volume intake and hourly urine output between the 2 groups in the first 24 h.

Conclusion

The implementation of fluid resuscitation using either protocol A or protocol B is safe and effective for pediatric burn patients in the first 24 h. The total fluid infused were similar between two protocols. But using protocol A may be more convenient and labor-saving for nurses.
Keywords:LA  lactic acid  BE  base excess  ACS  abdominal compartment syndrome  TMMU  Third Military Medical University  TBSA  total burn surface area  BW  body weight  BICU  Burn Intensive Care Unit  Fluid resuscitation  Pediatric burn  Fluid management protocol
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