Fluid resuscitation in thermally injured pediatric patients. 1997

Z Marinov, and K Kvalténi, and J Koller
Burn Center, General Hospital Ruzinov, Bratislava, Slovakia.

More than two-thirds of critical burns in special burn units are children. The burned child continues to represent a special challenge, since resuscitation therapy must be more precise than that for an adult with a similar burn. Children have a limited physiologic reserve and the pediatric fluid replacement therapy is based on the principle of separate calculation of physiological and pathological losses. We have reviewed the most widely accepted pediatric isotonic fluid protocols. All these protocols calculate for replacement of pathological losses with a need of 2 ml/kg/% BSAB (body surface area burn) or 4 ml/kg/% BSAB. We choosed the formulas of two Shriner's Burns Institutes--the Cincinnati and the Galveston Unit as representatives, and calculated the fluid therapy for model burn children weights of 10 kg, 30 kg with 20, 40, 60, 80% BSAB. The results of calculations where compared with physiologic parameters of children. In conclusions we could show, that the 4 ml/kg/% BSAB formulas do replace all theoretically predicted pathophysiologic losses due to burns. However, the 2 ml/kg/% BSAB formulas are more practical as a guideline for resuscitation of pediatric patients because of greater therapeutical range and better clinical response of children threatened by burn shock. It is important to remember that all formulas are only guides to fluid therapy, they should be modified according to individual needs and clinical status of the patient. Only successful restoring and maintaining perfusion pressures leads to optimal oxygenation of injured and noninjured tissues, which promotes spontaneous healing, prevents wound conversion, minimise bacterial colonisation, and prepares the injured areas for early grafting.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D012151 Resuscitation The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed) Resuscitations
D001830 Body Surface Area The two dimensional measure of the outer layer of the body. Area, Body Surface,Areas, Body Surface,Body Surface Areas,Surface Area, Body,Surface Areas, Body
D002056 Burns Injuries to tissues caused by contact with heat, steam, chemicals (BURNS, CHEMICAL), electricity (BURNS, ELECTRIC), or the like. Burn
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D002985 Clinical Protocols Precise and detailed plans for the study of a medical or biomedical problem and/or plans for a regimen of therapy. Protocols, Clinical,Research Protocols, Clinical,Treatment Protocols,Clinical Protocol,Clinical Research Protocol,Clinical Research Protocols,Protocol, Clinical,Protocol, Clinical Research,Protocols, Clinical Research,Protocols, Treatment,Research Protocol, Clinical,Treatment Protocol
D005440 Fluid Therapy Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to WATER-ELECTROLYTE BALANCE. Fluids may be administered intravenously, orally, by intermittent gavage, or by HYPODERMOCLYSIS. Oral Rehydration Therapy,Rehydration,Rehydration, Oral,Oral Rehydration,Rehydration Therapy, Oral,Therapy, Fluid,Therapy, Oral Rehydration,Fluid Therapies,Oral Rehydration Therapies,Oral Rehydrations,Rehydration Therapies, Oral,Rehydrations,Rehydrations, Oral,Therapies, Fluid,Therapies, Oral Rehydration
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D017668 Age of Onset The age, developmental stage, or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. Age-at-Onset,Age at Onset,Onset Age

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