The comparison of early fluid therapy in extensive flame burns between inhalation and noninhalation injuries

Niann Tzyy Dai, Tim Mo Chen, Tian Yeu Cheng, Shou Liang Chen, Shyi Gen Chen, Giuen Hsueng Chou, Trong Duo Chou, Hsian-Jenn Wang

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Abstract

Over the last half century, advances in treatment have changed the principal cause of death in burn patients from burn shock and wound sepsis to pulmonary sepsis, of which inhalation injury has always played a key role in morbidity and mortality. Even though Navar et al. have noted that patients with inhalation injury had a mean fluid requirement of 5.8 ml/kg/% burn to achieve resuscitation from early burn shock, while patients without inhalation injury required only a mean fluid of 4.0 ml/kg/% burn, to achieve successful resuscitation in inhalation injured patients with minimum but adequate fluid has always been a challenge. To further define the difference of early fluid therapy between inhalation and noninhalation in extensively burned patients, a retrospective analysis was carried out in the Tri-Service General Hospital. Sixty-two flame burned patients (aged from 16 to 81 years-old with a mean age of 33.2 ± 15.1 years; with burn size ranging from 30% to 98% TBSA with a mean burn size of 60.5 ± 22.7%; 26 with inhalation injury; noninhalation 36) were reviewed during a 5-year period. The Parkland formula is the initial choice of fluid regimen with 4 ml/kg/% burn and the amount of replacement is monitored by urine output and is titrated to maintain urine output between 0.5 and 1.0 ml/kg/h. The mean amounts of fluid requirements of both inhalation and noninhalation burned patients were 3.1 ± 1.0 and 2.3 ± 0.8 ml/kg/% burn respectively (p < 0.05). Our study showed less fluid requirement for both inhalation and noninhalation injured patients in comparison with the Navar study and Parkland predictions in the first 24 h postburn. Furthermore, the inhalation injured patients definitely required volumes of fluid in excess of those required in noninhalation injured cases.

Original languageEnglish
Pages (from-to)671-675
Number of pages5
JournalBurns
Volume24
Issue number7
DOIs
Publication statusPublished - Nov 1 1998
Externally publishedYes

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Keywords

  • Flame burn
  • Fluid therapy
  • Inhalation injury
  • Noninhalation injury

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Dai, N. T., Chen, T. M., Cheng, T. Y., Chen, S. L., Chen, S. G., Chou, G. H., Chou, T. D., & Wang, H-J. (1998). The comparison of early fluid therapy in extensive flame burns between inhalation and noninhalation injuries. Burns, 24(7), 671-675. https://doi.org/10.1016/S0305-4179(98)00092-8