Volume Resuscitation in Patients With High-Voltage Electrical Injuries

Derek M. Culnan, Kelley Farner, Genevieve H. Bitz, Karel D. Capek, Yiji Tu, Carlos Jimenez, William C. Lineaweaver

Research output: Contribution to journalReview article

Abstract

Volume resuscitation of patients with high-voltage electrical injuries (>1000 V) is a more complex challenge than standard burn resuscitation. High voltages penetrate deep tissues. These deep injuries are not accounted for in resuscitation formulae dependent on percentage of cutaneous burn. Myonecrosis occurring from direct electrical injury and secondary compartment syndromes can result in rhabdomyolysis, compromising renal function and urine output. Urine output is the primary end point, with a goal of 1 mL/kg/h for adult patients with high-voltage electrical injuries. As such, secondary resuscitation end points of laboratory values, such as lactate, base deficit, hemoglobin, and creatinine, as well as hemodynamic monitoring, such as mean arterial pressure and thermodilution techniques, can become crucial in guiding optimum administration of resuscitation fluids. Mannitol and bicarbonates are available but have limited support in the literature. High-voltage electrical injury patients often develop acute kidney injury requiring dialysis and have increased risks of chronic kidney disease and mortality. Continuous venovenous hemofiltration is a well-supported adjunct to clear the myoglobin load that hemodialysis cannot from circulation.

Original languageEnglish (US)
Pages (from-to)S113-S118
JournalAnnals of plastic surgery
Volume80
Issue number3
DOIs
StatePublished - Mar 1 2018
Externally publishedYes

Fingerprint

Resuscitation
Wounds and Injuries
Urine
Compartment Syndromes
Hemofiltration
Thermodilution
Rhabdomyolysis
Myoglobin
Mannitol
Bicarbonates
Chronic Renal Insufficiency
Acute Kidney Injury
Renal Dialysis
Dialysis
Lactic Acid
Creatinine
Arterial Pressure
Hemoglobins
Hemodynamics
Kidney

ASJC Scopus subject areas

  • Surgery

Cite this

Culnan, D. M., Farner, K., Bitz, G. H., Capek, K. D., Tu, Y., Jimenez, C., & Lineaweaver, W. C. (2018). Volume Resuscitation in Patients With High-Voltage Electrical Injuries. Annals of plastic surgery, 80(3), S113-S118. https://doi.org/10.1097/SAP.0000000000001374

Volume Resuscitation in Patients With High-Voltage Electrical Injuries. / Culnan, Derek M.; Farner, Kelley; Bitz, Genevieve H.; Capek, Karel D.; Tu, Yiji; Jimenez, Carlos; Lineaweaver, William C.

In: Annals of plastic surgery, Vol. 80, No. 3, 01.03.2018, p. S113-S118.

Research output: Contribution to journalReview article

Culnan, DM, Farner, K, Bitz, GH, Capek, KD, Tu, Y, Jimenez, C & Lineaweaver, WC 2018, 'Volume Resuscitation in Patients With High-Voltage Electrical Injuries', Annals of plastic surgery, vol. 80, no. 3, pp. S113-S118. https://doi.org/10.1097/SAP.0000000000001374
Culnan, Derek M. ; Farner, Kelley ; Bitz, Genevieve H. ; Capek, Karel D. ; Tu, Yiji ; Jimenez, Carlos ; Lineaweaver, William C. / Volume Resuscitation in Patients With High-Voltage Electrical Injuries. In: Annals of plastic surgery. 2018 ; Vol. 80, No. 3. pp. S113-S118.
@article{4686909b738342489d8075442e7ef1fd,
title = "Volume Resuscitation in Patients With High-Voltage Electrical Injuries",
abstract = "Volume resuscitation of patients with high-voltage electrical injuries (>1000 V) is a more complex challenge than standard burn resuscitation. High voltages penetrate deep tissues. These deep injuries are not accounted for in resuscitation formulae dependent on percentage of cutaneous burn. Myonecrosis occurring from direct electrical injury and secondary compartment syndromes can result in rhabdomyolysis, compromising renal function and urine output. Urine output is the primary end point, with a goal of 1 mL/kg/h for adult patients with high-voltage electrical injuries. As such, secondary resuscitation end points of laboratory values, such as lactate, base deficit, hemoglobin, and creatinine, as well as hemodynamic monitoring, such as mean arterial pressure and thermodilution techniques, can become crucial in guiding optimum administration of resuscitation fluids. Mannitol and bicarbonates are available but have limited support in the literature. High-voltage electrical injury patients often develop acute kidney injury requiring dialysis and have increased risks of chronic kidney disease and mortality. Continuous venovenous hemofiltration is a well-supported adjunct to clear the myoglobin load that hemodialysis cannot from circulation.",
author = "Culnan, {Derek M.} and Kelley Farner and Bitz, {Genevieve H.} and Capek, {Karel D.} and Yiji Tu and Carlos Jimenez and Lineaweaver, {William C.}",
year = "2018",
month = "3",
day = "1",
doi = "10.1097/SAP.0000000000001374",
language = "English (US)",
volume = "80",
pages = "S113--S118",
journal = "Annals of Plastic Surgery",
issn = "0148-7043",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Volume Resuscitation in Patients With High-Voltage Electrical Injuries

AU - Culnan, Derek M.

AU - Farner, Kelley

AU - Bitz, Genevieve H.

AU - Capek, Karel D.

AU - Tu, Yiji

AU - Jimenez, Carlos

AU - Lineaweaver, William C.

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Volume resuscitation of patients with high-voltage electrical injuries (>1000 V) is a more complex challenge than standard burn resuscitation. High voltages penetrate deep tissues. These deep injuries are not accounted for in resuscitation formulae dependent on percentage of cutaneous burn. Myonecrosis occurring from direct electrical injury and secondary compartment syndromes can result in rhabdomyolysis, compromising renal function and urine output. Urine output is the primary end point, with a goal of 1 mL/kg/h for adult patients with high-voltage electrical injuries. As such, secondary resuscitation end points of laboratory values, such as lactate, base deficit, hemoglobin, and creatinine, as well as hemodynamic monitoring, such as mean arterial pressure and thermodilution techniques, can become crucial in guiding optimum administration of resuscitation fluids. Mannitol and bicarbonates are available but have limited support in the literature. High-voltage electrical injury patients often develop acute kidney injury requiring dialysis and have increased risks of chronic kidney disease and mortality. Continuous venovenous hemofiltration is a well-supported adjunct to clear the myoglobin load that hemodialysis cannot from circulation.

AB - Volume resuscitation of patients with high-voltage electrical injuries (>1000 V) is a more complex challenge than standard burn resuscitation. High voltages penetrate deep tissues. These deep injuries are not accounted for in resuscitation formulae dependent on percentage of cutaneous burn. Myonecrosis occurring from direct electrical injury and secondary compartment syndromes can result in rhabdomyolysis, compromising renal function and urine output. Urine output is the primary end point, with a goal of 1 mL/kg/h for adult patients with high-voltage electrical injuries. As such, secondary resuscitation end points of laboratory values, such as lactate, base deficit, hemoglobin, and creatinine, as well as hemodynamic monitoring, such as mean arterial pressure and thermodilution techniques, can become crucial in guiding optimum administration of resuscitation fluids. Mannitol and bicarbonates are available but have limited support in the literature. High-voltage electrical injury patients often develop acute kidney injury requiring dialysis and have increased risks of chronic kidney disease and mortality. Continuous venovenous hemofiltration is a well-supported adjunct to clear the myoglobin load that hemodialysis cannot from circulation.

UR - http://www.scopus.com/inward/record.url?scp=85071740594&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85071740594&partnerID=8YFLogxK

U2 - 10.1097/SAP.0000000000001374

DO - 10.1097/SAP.0000000000001374

M3 - Review article

C2 - 29461290

AN - SCOPUS:85071740594

VL - 80

SP - S113-S118

JO - Annals of Plastic Surgery

JF - Annals of Plastic Surgery

SN - 0148-7043

IS - 3

ER -