Open AccessFluid Restriction for Treatment of “Fluid Creep” after Acute Burn Resuscitation
Author(s) -
Tang YW,
Chen IC,
Yen JH,
Lu CT,
Lai CS,
Liu HJ,
Chang HC,
Chen YW
Publication year - 2014
Publication title -
hong kong journal of emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.145
H-Index - 12
eISSN - 2309-5407
pISSN - 1024-9079
DOI - 10.1177/102490791402100404
Subject(s) - medicine , resuscitation , urine output , body weight , total body surface area , intravenous fluid , pulmonary injury , fluid intake , anesthesia , body fluid , fluid replacement , surgery , lung , creatinine , pulmonary fibrosis
Objective Fluid creep in patients recovering from acute burns still exists, despite the use of a more treatment conservative approach. Most of our severe burn patients develop fluid overload and body weight increase after acute fluid resuscitation. How to quickly return patients to their pre‐injury body weight is an important issue. Methods Right after acute fluid resuscitation, we applied a “total fluid requirement” volume (usually 1/2 to 2/3 of initial 24 hour volume) and strictly monitored patients' hourly urine (between 0.5‐1 ml/kg/hr). Patients' responses (body weight, enteric feeding amount, pulmonary condition, etc.) were also closely monitored and frequent adjustments of fluid volume administration were performed simultaneously. Results Most patients regained their pre‐injury body weight within 2‐3 weeks. Enteric feeding also improved markedly. No patients had severe oedema‐related complications. Conclusions Stricter fluid administration after acute burn fluid resuscitation is advised for allowing patients to reduce body weight to their pre‐injury weight or at least close to it. We use pre‐injury body weight, enteric feeding and urine output as our guides. (Hong Kong j.emerg.med. 2014;21:222‐229)