Resuscitation, anaesthesia and analgesia of the burned patient.

Détails

ID Serval
serval:BIB_ABD67E2F8599
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Resuscitation, anaesthesia and analgesia of the burned patient.
Périodique
Current Opinion in Anaesthesiology
Auteur(s)
Berger M.M., Bernath M.A., Chioléro R.L.
ISSN
0952-7907
Statut éditorial
Publié
Date de publication
08/2001
Peer-reviewed
Oui
Volume
14
Numéro
4
Pages
431-435
Langue
anglais
Notes
Publication types: Journal Article
Résumé
Burns resuscitation has evolved over the past few decades towards more evidence-based management. It has been shown that patients with major burns (i.e. involving more than 30% of the body surface) benefit from invasive monitoring, and physiological variable targeted resuscitation using vasoactive agents for cardiovascular support. The invasive approach results in a reduction of mortality rates. Since the introduction of the Parkland formula in 1968, there has been a trend towards the administration of fluid resuscitation far in excess of the volume predicted with this formula. This has led to an increase in complication rates, with more pulmonary oedema, and the appearance of abdominal compartment syndrome. Hypertonic saline solutions, whether with dextran or not, have shown no advantage over the classic Ringer's lactate solution. The colloid controversy has reached burns resuscitation, with the demonstration that the liberal use of albumin is associated with higher mortality rates. Fresh frozen plasma should only be used for specific coagulation disorders. On the other hand, artificial colloids, particularly gelatine, remain a useful tool in patients with major burns and haemodynamic instability, particularly, and can be given as early as 6 h after injury. Considering the actual evidence, using inotropes and vasopressors to reach supranormal haemodynamic endpoints seems preferable to delivering unrestricted amounts of fluid.
Pubmed
Création de la notice
24/01/2008 17:52
Dernière modification de la notice
20/08/2019 16:15
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