Evaluation of hyperdynamic resuscitation in 60% TBSA burn-injured sheep.

Alia Shah, Cara M. Connolly, Robert A. Kirschner, David Herndon, George Kramer

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

It has been suggested that hyperdynamic (HD) resuscitation improves outcomes. We hypothesized that initial HD resuscitation of burn injury using fluid and inotropes would improve metabolic function as indicated by base excess. We used an anesthetized ovine model of 60% TBSA full-thickness flame burn with delayed resuscitation started at 90 min after burn and continued for 8 h. Three groups (n = 6 each) were included: 1) HD defined as cardiac index (CI) of 1.5x baseline achieved by using Ringer's lactate alone (HD-Fluid); 2) Ringer's lactate and dobutamine (HD-Drug); and 3) Parkland Formula (Parkland) as a control group. Statistical analysis performed using analysis of variance and Tukey's HSD test. Significance accepted at P < 0.05. Higher CI was achieved in both HD-Fluid and HD-Drug groups, e.g., at 8 h the CI was 4.6 +/- 0.4 and 4.7 +/- 0.6 L/min/m respectively, as compared with Parkland 3.6 +/- 0.5 L/min/m. The net fluid balance (fluid infused - urine output) was similar in both Parkland and HD-Drug groups, which were 2.5x more in HD-Fluid (P = 0.001). The mean postburn urinary outputs were similar in both Parkland and HD-Drug groups, e.g., Parkland (0.9 +/- 0.08 mL/kg/h), HD-Drug (1.0 +/- 0.2 mL/kg/h) and increased in HD-Fluid (3.7 +/- 1.0 mL/kg/h; P = 0.0005). Base excess remained positive in both HD-Drug (+2.5 +/- 1 mmol/L) and Parkland (+1.5 +/- 1.7 mmol/L), and declined to -4.0 +/- 3.6 mmol/L in HD-Fluid group (P = 0.036). We conclude that there may be no benefit to using hyperdynamic regimens for the initial resuscitation of burn injury.

Original languageEnglish (US)
Pages (from-to)86-92
Number of pages7
JournalShock (Augusta, Ga.)
Volume21
Issue number1
StatePublished - Jan 2004

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Burns
Resuscitation
Sheep
Pharmaceutical Preparations
Water-Electrolyte Balance
Dobutamine
Wounds and Injuries
Analysis of Variance
Urine
Control Groups

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Physiology

Cite this

Shah, A., Connolly, C. M., Kirschner, R. A., Herndon, D., & Kramer, G. (2004). Evaluation of hyperdynamic resuscitation in 60% TBSA burn-injured sheep. Shock (Augusta, Ga.), 21(1), 86-92.

Evaluation of hyperdynamic resuscitation in 60% TBSA burn-injured sheep. / Shah, Alia; Connolly, Cara M.; Kirschner, Robert A.; Herndon, David; Kramer, George.

In: Shock (Augusta, Ga.), Vol. 21, No. 1, 01.2004, p. 86-92.

Research output: Contribution to journalArticle

Shah, A, Connolly, CM, Kirschner, RA, Herndon, D & Kramer, G 2004, 'Evaluation of hyperdynamic resuscitation in 60% TBSA burn-injured sheep.', Shock (Augusta, Ga.), vol. 21, no. 1, pp. 86-92.
Shah A, Connolly CM, Kirschner RA, Herndon D, Kramer G. Evaluation of hyperdynamic resuscitation in 60% TBSA burn-injured sheep. Shock (Augusta, Ga.). 2004 Jan;21(1):86-92.
Shah, Alia ; Connolly, Cara M. ; Kirschner, Robert A. ; Herndon, David ; Kramer, George. / Evaluation of hyperdynamic resuscitation in 60% TBSA burn-injured sheep. In: Shock (Augusta, Ga.). 2004 ; Vol. 21, No. 1. pp. 86-92.
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abstract = "It has been suggested that hyperdynamic (HD) resuscitation improves outcomes. We hypothesized that initial HD resuscitation of burn injury using fluid and inotropes would improve metabolic function as indicated by base excess. We used an anesthetized ovine model of 60{\%} TBSA full-thickness flame burn with delayed resuscitation started at 90 min after burn and continued for 8 h. Three groups (n = 6 each) were included: 1) HD defined as cardiac index (CI) of 1.5x baseline achieved by using Ringer's lactate alone (HD-Fluid); 2) Ringer's lactate and dobutamine (HD-Drug); and 3) Parkland Formula (Parkland) as a control group. Statistical analysis performed using analysis of variance and Tukey's HSD test. Significance accepted at P < 0.05. Higher CI was achieved in both HD-Fluid and HD-Drug groups, e.g., at 8 h the CI was 4.6 +/- 0.4 and 4.7 +/- 0.6 L/min/m respectively, as compared with Parkland 3.6 +/- 0.5 L/min/m. The net fluid balance (fluid infused - urine output) was similar in both Parkland and HD-Drug groups, which were 2.5x more in HD-Fluid (P = 0.001). The mean postburn urinary outputs were similar in both Parkland and HD-Drug groups, e.g., Parkland (0.9 +/- 0.08 mL/kg/h), HD-Drug (1.0 +/- 0.2 mL/kg/h) and increased in HD-Fluid (3.7 +/- 1.0 mL/kg/h; P = 0.0005). Base excess remained positive in both HD-Drug (+2.5 +/- 1 mmol/L) and Parkland (+1.5 +/- 1.7 mmol/L), and declined to -4.0 +/- 3.6 mmol/L in HD-Fluid group (P = 0.036). We conclude that there may be no benefit to using hyperdynamic regimens for the initial resuscitation of burn injury.",
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