A protocol guided by transpulmonary thermodilution and lactate levels for resuscitation of patients with severe burns.

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Version: author
Serval ID
serval:BIB_02F367D38F5D
Type
Article: article from journal or magazin.
Publication sub-type
Editorial
Collection
Publications
Institution
Title
A protocol guided by transpulmonary thermodilution and lactate levels for resuscitation of patients with severe burns.
Journal
Critical Care
Author(s)
Berger M.M., Que Y.A.
ISSN
1466-609X (Electronic)
ISSN-L
1364-8535
Publication state
Published
Issued date
2013
Peer-reviewed
Oui
Volume
17
Number
5
Pages
195
Language
english
Notes
Publication types: EDITORIAL . pdf type: commentary (as en editorial)
Abstract
Over-resuscitation is deleterious in many critically ill conditions, including major burns. For more than 15 years, several strategies to reduce fluid administration in burns during the initial resuscitation phase have been proposed, but no single or simple parameter has shown superiority. Fluid administration guided by invasive hemodynamic parameters usually resulted in over-resuscitation. As reported in the previous issue of Critical Care, Sánchez-Sánchez and colleagues analyzed the performance of a 'permissive hypovolemia' protocol guided by invasive hemodynamic parameters (PiCCO, Pulsion Medical Systems, Munich, Germany) and vital signs in a prospective cohort over a 3-year period. The authors' results confirm that resuscitation can be achieved with below-normal levels of preload but at the price of a fluid administration greater than predicted by the Parkland formula (2 to 4 mL/kg per% burn). The classic approach based on an adapted Parkland equation may still be the simplest until further studies identify the optimal bundle of resuscitation goals.
Pubmed
Web of science
Open Access
Yes
Create date
08/01/2014 16:29
Last modification date
20/08/2019 12:25
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