Arterial thermodilution in burn patients suggests a more rapid fluid administration during early resuscitation

C. Csontos, V. Foldi, T. Fischer, L. Bogar

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: A number of target points have been used for fluid replacement in severely burned patients. The aim of our prospective randomized study was to compare the effect of two different types of fluid resuscitation regimes on the multiple organ dysfunction score (MODS) and central venous oxygen saturation (ScvO2) in the first 3 days after injury. Methods: Twenty-four patients admitted to the critical care unit of a university hospital with the presence of burn injury affecting more than 15% of the body surface area and in-hospital fluid resuscitation started within 3 h after burn injury were included. Patients were randomized into two groups. Fluid resuscitation was guided by the hourly urine output (HUO Group, n=12) or by the intrathoracic blood volume index (ITBVI Group, n=12). Invasive transpulmonary hemodynamic measurements utilizing pulse contour analysis with a single dilution technique and continuous ScvO2 measurements were performed in both groups. Results: The mean ScvO2 was significantly lower in the HUO Group than in the ITBVI Group (P=0.024) for the first 24 h. MODS was significantly higher in the HUO Group than in the ITBVI group 48 h (P=0.024) and 72 h after injury (P=0.014). The two main outcome parameters, i.e., MODS calculated at 48 and 72 h after injury and ScvO2 were negatively correlated on day 1 (r=-0.684, P=0.004, r=-0.677, P=0.003). There were no statistical differences in clinical outcome parameters. Conclusion: Our data suggest that ITBVI may be a better target parameter than HOU in the fluid resuscitation of severely burned patients after injury.

Original languageEnglish
Pages (from-to)742-749
Number of pages8
JournalActa Anaesthesiologica Scandinavica
Volume52
Issue number6
DOIs
Publication statusPublished - Jul 2008

Fingerprint

Thermodilution
Resuscitation
Organ Dysfunction Scores
Wounds and Injuries
Indicator Dilution Techniques
Body Surface Area
Critical Care
Blood Volume
Hemodynamics
Urine
Prospective Studies
Oxygen

Keywords

  • Arterial thermodilution
  • Burn injury
  • Fluid resuscitation

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Arterial thermodilution in burn patients suggests a more rapid fluid administration during early resuscitation. / Csontos, C.; Foldi, V.; Fischer, T.; Bogar, L.

In: Acta Anaesthesiologica Scandinavica, Vol. 52, No. 6, 07.2008, p. 742-749.

Research output: Contribution to journalArticle

@article{55348220a5cb46a2ae27b4fb67da946b,
title = "Arterial thermodilution in burn patients suggests a more rapid fluid administration during early resuscitation",
abstract = "Background: A number of target points have been used for fluid replacement in severely burned patients. The aim of our prospective randomized study was to compare the effect of two different types of fluid resuscitation regimes on the multiple organ dysfunction score (MODS) and central venous oxygen saturation (ScvO2) in the first 3 days after injury. Methods: Twenty-four patients admitted to the critical care unit of a university hospital with the presence of burn injury affecting more than 15{\%} of the body surface area and in-hospital fluid resuscitation started within 3 h after burn injury were included. Patients were randomized into two groups. Fluid resuscitation was guided by the hourly urine output (HUO Group, n=12) or by the intrathoracic blood volume index (ITBVI Group, n=12). Invasive transpulmonary hemodynamic measurements utilizing pulse contour analysis with a single dilution technique and continuous ScvO2 measurements were performed in both groups. Results: The mean ScvO2 was significantly lower in the HUO Group than in the ITBVI Group (P=0.024) for the first 24 h. MODS was significantly higher in the HUO Group than in the ITBVI group 48 h (P=0.024) and 72 h after injury (P=0.014). The two main outcome parameters, i.e., MODS calculated at 48 and 72 h after injury and ScvO2 were negatively correlated on day 1 (r=-0.684, P=0.004, r=-0.677, P=0.003). There were no statistical differences in clinical outcome parameters. Conclusion: Our data suggest that ITBVI may be a better target parameter than HOU in the fluid resuscitation of severely burned patients after injury.",
keywords = "Arterial thermodilution, Burn injury, Fluid resuscitation",
author = "C. Csontos and V. Foldi and T. Fischer and L. Bogar",
year = "2008",
month = "7",
doi = "10.1111/j.1399-6576.2008.01658.x",
language = "English",
volume = "52",
pages = "742--749",
journal = "Acta Anaesthesiologica Scandinavica",
issn = "0001-5172",
publisher = "Blackwell Munksgaard",
number = "6",

}

TY - JOUR

T1 - Arterial thermodilution in burn patients suggests a more rapid fluid administration during early resuscitation

AU - Csontos, C.

AU - Foldi, V.

AU - Fischer, T.

AU - Bogar, L.

PY - 2008/7

Y1 - 2008/7

N2 - Background: A number of target points have been used for fluid replacement in severely burned patients. The aim of our prospective randomized study was to compare the effect of two different types of fluid resuscitation regimes on the multiple organ dysfunction score (MODS) and central venous oxygen saturation (ScvO2) in the first 3 days after injury. Methods: Twenty-four patients admitted to the critical care unit of a university hospital with the presence of burn injury affecting more than 15% of the body surface area and in-hospital fluid resuscitation started within 3 h after burn injury were included. Patients were randomized into two groups. Fluid resuscitation was guided by the hourly urine output (HUO Group, n=12) or by the intrathoracic blood volume index (ITBVI Group, n=12). Invasive transpulmonary hemodynamic measurements utilizing pulse contour analysis with a single dilution technique and continuous ScvO2 measurements were performed in both groups. Results: The mean ScvO2 was significantly lower in the HUO Group than in the ITBVI Group (P=0.024) for the first 24 h. MODS was significantly higher in the HUO Group than in the ITBVI group 48 h (P=0.024) and 72 h after injury (P=0.014). The two main outcome parameters, i.e., MODS calculated at 48 and 72 h after injury and ScvO2 were negatively correlated on day 1 (r=-0.684, P=0.004, r=-0.677, P=0.003). There were no statistical differences in clinical outcome parameters. Conclusion: Our data suggest that ITBVI may be a better target parameter than HOU in the fluid resuscitation of severely burned patients after injury.

AB - Background: A number of target points have been used for fluid replacement in severely burned patients. The aim of our prospective randomized study was to compare the effect of two different types of fluid resuscitation regimes on the multiple organ dysfunction score (MODS) and central venous oxygen saturation (ScvO2) in the first 3 days after injury. Methods: Twenty-four patients admitted to the critical care unit of a university hospital with the presence of burn injury affecting more than 15% of the body surface area and in-hospital fluid resuscitation started within 3 h after burn injury were included. Patients were randomized into two groups. Fluid resuscitation was guided by the hourly urine output (HUO Group, n=12) or by the intrathoracic blood volume index (ITBVI Group, n=12). Invasive transpulmonary hemodynamic measurements utilizing pulse contour analysis with a single dilution technique and continuous ScvO2 measurements were performed in both groups. Results: The mean ScvO2 was significantly lower in the HUO Group than in the ITBVI Group (P=0.024) for the first 24 h. MODS was significantly higher in the HUO Group than in the ITBVI group 48 h (P=0.024) and 72 h after injury (P=0.014). The two main outcome parameters, i.e., MODS calculated at 48 and 72 h after injury and ScvO2 were negatively correlated on day 1 (r=-0.684, P=0.004, r=-0.677, P=0.003). There were no statistical differences in clinical outcome parameters. Conclusion: Our data suggest that ITBVI may be a better target parameter than HOU in the fluid resuscitation of severely burned patients after injury.

KW - Arterial thermodilution

KW - Burn injury

KW - Fluid resuscitation

UR - http://www.scopus.com/inward/record.url?scp=45149098751&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=45149098751&partnerID=8YFLogxK

U2 - 10.1111/j.1399-6576.2008.01658.x

DO - 10.1111/j.1399-6576.2008.01658.x

M3 - Article

VL - 52

SP - 742

EP - 749

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 6

ER -