Acute Fluid Management of Large Burns: Pathophysiology, Monitoring, and Resuscitation

Justin Gillenwater; Warren Garner

doi:10.1016/j.cps.2017.02.008

Acute Fluid Management of Large Burns: Pathophysiology, Monitoring, and Resuscitation

Clin Plast Surg. 2017 Jul;44(3):495-503. doi: 10.1016/j.cps.2017.02.008. Epub 2017 Apr 14.

Authors

Justin Gillenwater¹, Warren Garner²

Affiliations

¹ Division of Plastic Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, Suite 415, Los Angeles, CA 90033, USA.
² Division of Plastic Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo Street, Suite 415, Los Angeles, CA 90033, USA. Electronic address: wgarner@med.usc.edu.

PMID: 28576238
DOI: 10.1016/j.cps.2017.02.008

Abstract

This article reviews the pathophysiology of large burn injury and the extreme fluid shifts that occur in the hours and days after this event. The authors focus on acute fluid management, monitoring of hemodynamic status, and end points of resuscitation. Understanding the need and causes for fluid resuscitation after burn injury helps the clinician develop an effective plan to balance the competing goals of normalized tissue perfusion and limited tissue edema. Thoughtful, individualized treatment is the best answer and the most effective compromise.

Keywords: Burn shock and burn edema; Colloid; Crystalloid; Fluid resuscitation.

Publication types

Review

MeSH terms

Algorithms
Burns / complications
Burns / physiopathology
Burns / therapy*
Fluid Therapy* / methods
Humans
Resuscitation / methods*
Systemic Inflammatory Response Syndrome / etiology
Systemic Inflammatory Response Syndrome / therapy