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A comparison of two different fluid resuscitation management protocols for pediatric burn patients: A retrospective
Miao Huang1, Jun-Feng Chen2, Li-Ying Chen3
1Department of Nursing, Guangzhou Red Cross Hospital, Fourth Affiliated Hospital of Jinan University, Guangzhou, 510220, China.
Insights
Two fluid resuscitation protocols for pediatric burn patients are safe and effective within the first 24 hours. Protocol A, while infusing more fluid, may be more convenient for nursing staff.
Area of Science:
- Pediatric critical care medicine
- Burn resuscitation science
- Fluid management strategies
Background:
- Pediatric burn patients face higher risks of burn shock compared to adults.
- Effective fluid management is crucial for successful resuscitation in pediatric burn cases.
- Early fluid resuscitation protocols are vital for optimizing outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of two distinct fluid resuscitation protocols.
- To compare fluid management strategies in pediatric burn patients within the initial 24 hours post-burn.
- To assess the impact of different fluid administration timings on patient outcomes.
Main Methods:
- A comparative study involving 113 pediatric burn patients from January 2007 to October 2012.
- Group A (n=57) received alternating crystalloids and colloids within 2 hours.
- Group B (n=56) received alternating crystalloids and colloids within 1 hour; safety, fluid volume, and urine output were monitored.
Main Results:
- All patients survived the initial 24-hour post-burn period.
- No significant differences were observed in lactic acid levels or base excess between the groups.
- Group A received a greater volume of infused water (P=0.024), but total intake and urine output were comparable.
Conclusions:
- Both fluid resuscitation protocols (A and B) are safe and effective for pediatric burn patients in the first 24 hours.
- While total fluid infused was similar, Protocol A may offer practical advantages in nursing convenience and labor efficiency.
- The findings support the use of either protocol for initial burn resuscitation in pediatric populations.
Objective:
Pediatric burn patients are more susceptible to burn shock than adults, and an effective fluid management protocol is critical to successful resuscitation. Our research aim was to investigate the safety and efficacy of two protocols for pediatric burn patients for use within the first 24h.
Methods:
A total of 113 pediatric burn patients were enrolled from January 2007 to October 2012. Of those patients, 57 received fluid titration regimens of alternating crystalloids and colloids once within 2h in the first 24h after burn (Group A), whereas the remaining patients received regimens of alternating crystalloids and colloids once within 1h in the first 24h after burn (Group B). The safety, fluid volume infused and urine output were recorded and compared.
Results:
All the patients survived in the first 24h after burn. There were no significant differences between Group A and Group B in lactic acid (LA) level and base excess (BE). The water infused in Group A were greater than that of Group B in the first 24h (P=0.024). No significant differences were found in total volume intake and hourly urine output between the 2 groups in the first 24h.
Conclusion:
The implementation of fluid resuscitation using either protocol A or protocol B is safe and effective for pediatric burn patients in the first 24h. The total fluid infused were similar between two protocols. But using protocol A may be more convenient and labor-saving for nurses.
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