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- Open Access
Initial resuscitation of burn patients: association between hemodynamic parameters and serum lactate level with 90-days mortality
© Soussi et al.; 2015
- Published: 1 October 2015
- Mean Arterial Pressure
- Cardiac Index
- Serum Lactate
- Total Body Surface Area
- Transpulmonary Thermodilution
To evaluate the association between the first 24 hours after admission systemic hemodynamics, central venous saturation (ScvO2), central venous to arterial carbon dioxide difference (PCO2gap) and serum lactate with the 90-days mortality in critically ill burn patients.
Burn patients with total body surface area (TBSA) greater than 20% admitted within 8 hours of thermal injury, with continuous cardiac output, ScvO2,PCO2gap and serum lactate monitoring during the first 24 hours after admission between march 2013 and October 2014, were included. Ringer Lactate was administered according to the Parkland formula (4ml/kg/% TBSA), and adjusted according to a local algorithm based on hemodynamic targets. Cardiac output was measured with the transpulmonary thermodilution method. All patients had invasive blood pressure monitoring. The primary study endpoint was 90-daysmortality. Results are indicated in median and (25-75) centiles. ANOVA test analysis or Mann-Whitney.
Admission serum lactate level in burn patients is a good biomarker to predict 90-days mortality. Initial CI and MAP seem to be lower in patients with poor prognosis but these differences disappeared with hemodynamic resuscitation. Our study suggests the necessary specific attention in pre-hospital phase and very early initial in-hospital resuscitation in severe burn patients.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.