Early fluid resuscitation improves outcomes in severely burned children

Robert E. Barrow, Marc G. Jeschke, David N. Herndon

Research output: Contribution to journalArticle

104 Scopus citations

Abstract

Background: Recent evidence suggests that timely fluid resuscitation can significantly reduce multiorgan failure and mortality in thermally injured children. In this study, children who received fluid resuscitation within 2 h of a thermal injury were compared with children in which fluid resuscitation was delayed by 2-12 h. We hypothesized that fluid resuscitation given within 2 h of a thermal injury attenuates renal failure, cardiac arrest, cardiac arrest deaths, incidence of sepsis, and overall mortality. Methods: A retrospective chart review was made on 133 children admitted to our institute from 1982 to 1999 with scald or flame burns covering more than 50% of their body surface area. Comparisons between early (< 2 h of injury) or delayed (≥ 2 h of injury) fluid resuscitation were made in children experiencing renal failure, sepsis, non-survivors with cardiac arrest requiring pulmonary and advanced life support, and overall mortality. Comparisons were made using the χ2-test with Yates' continuity correction and joint binomial confidence intervals using the Bonferroni correction. Results: The incidence of sepsis, renal failure, non-survivors with cardiac arrest, and overall mortality was significantly higher in burned children receiving fluid resuscitation that was delayed by 2 h or more compared with those receiving fluid resuscitation within 2 h of thermal injury (P < 0.001). Conclusions: Data suggest that fluid resuscitation, given within 2 h of a thermal injury, may be one of the most important steps in the prevention of multi-organ failure and mortality. (C) 2000 Elsevier Science Ireland Ltd.

Original languageEnglish (US)
Pages (from-to)91-96
Number of pages6
JournalResuscitation
Volume45
Issue number2
DOIs
StatePublished - Sep 13 2000

Keywords

  • Burns
  • Cardiac arrest
  • Fluid resuscitation
  • Multi-organ failure
  • Outcomes
  • Pediatrics
  • Renal failure
  • Sepsis

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

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