Computerized decision support system improves fluid resuscitation following severe burns: an original study

Area of Science:

• Trauma Surgery
• Critical Care Medicine
• Biomedical Engineering

Background:

• Traditional fluid resuscitation formulas for severe burns require manual titration, increasing the risk of human error and suboptimal patient outcomes.
• Developing accurate and efficient fluid management strategies is crucial for severely burned patients.

Purpose of the Study:

• To evaluate the efficacy of a computerized open-loop decision support system for burn resuscitation compared to historical controls.
• To analyze the impact of automated fluid management on patient outcomes.

Main Methods:

• A fluid-response model was developed using data from 39 severely burned patients (>20% total body surface area).
• This model was integrated into a computerized open-loop algorithm and decision support system.
• The system was used to guide resuscitation in 32 subsequent severe burn patients and compared to the initial cohort.

Main Results:

• No significant differences in patient demographics or injury mechanisms were observed between the groups.
• The computerized system group received significantly lower total crystalloid volumes (first 48 hours, ICU stay, initial 24 hours) per patient and per kilogram body weight/percentage burn.
• A higher percentage of patients in the computerized system group met hourly urinary output goals.

Conclusions:

• A computerized decision support system significantly improved fluid management in severely burned patients within an intensive care unit setting.
• The system reduced crystalloid fluid administration while maintaining adequate urinary output, indicating enhanced patient care.
• Computerized decision support technology represents a valuable advancement in the management of severe burn injuries.