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Effectiveness of burns resuscitation using two different formulae.
M S Murison1, J K Laitung, R W Pigott
1Department of Plastic and Reconstructive Surgery, Frenchay Hospital, Bristol, UK.
Burns : Journal of the International Society for Burn Injuries
|December 1, 1991
Summary
The Watson-Walker modification for burn resuscitation in 1989 did not improve patient outcomes. This revised fluid resuscitation protocol led to overtransfusion without reducing morbidity or mortality.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Burn Care
Background:
- Historically, burn resuscitation at Frenchay Hospital utilized the Mount Vernon formula.
- In 1989, a modified resuscitation protocol (Watson-Walker modification) was implemented.
Purpose of the Study:
- To retrospectively evaluate the impact of the modified burn resuscitation protocol on patient morbidity and mortality.
- To compare outcomes between the standard Mount Vernon formula and the Watson-Walker modification.
Main Methods:
- Retrospective analysis of adult and pediatric burn patients admitted in 1988 (pre-modification) and 1989 (post-modification).
- Comparison of patient demographics, burn characteristics, resuscitation volumes, and clinical outcomes.
- Statistical analysis to determine significant differences between the two groups.
Main Results:
- No significant differences in age, body weight, burn distribution, or arrival delay were observed between the groups.
- Patients in 1989 received greater volumes of fluid resuscitation, leading to increased urine output (indicative of overtransfusion).
- Albumin administration exceeded calculated requirements in both years, particularly after the third period.
Conclusions:
- The Watson-Walker modification for burn resuscitation is deemed unnecessary.
- The modified protocol may lead to undesirable overtransfusion without demonstrable benefits in morbidity or mortality.
- The standard Mount Vernon formula remains a suitable approach for burn resuscitation.