Related Experiment Video
Updated: Dec 27, 2025
Rat Burn Model to Study Full-Thickness Cutaneous Thermal Burn and Infection
Published on: August 23, 2022
Association between fluid creep and infection in burned children: A cohort study
Maria Helena M Dittrich1, Nicole Dittrich Hosni1, Werther B de Carvalho2
1Federal University of São Paulo, Escola Paulista De Medicina, São Paulo, Brazil.
Insights
Early albumin resuscitation in burn children significantly reduced fluid creep and hospital stay, lowering infection risk. This approach improves outcomes for pediatric burn patients, decreasing mortality associated with sepsis.
Area of Science:
- Pediatric Burn Care
- Fluid Resuscitation Strategies
- Infection Control in Burn Patients
Background:
- Fluid creep is a critical factor in burn patient morbidity and mortality.
- Sepsis is the primary cause of death in burn shock survivors.
- Optimizing fluid resuscitation is crucial for managing burn injuries in children.
Purpose of the Study:
- To investigate the association between fluid creep and infection in pediatric burn patients.
- To compare two fluid resuscitation strategies using albumin in burn children.
Main Methods:
- A cohort of 46 burn children (15-45% BSA) were divided into early (8-12h) and delayed (>24h) albumin groups.
- Outcomes measured included fluid creep, hospital length of stay, surgical procedures, and infection rates.
- Statistical analysis compared outcomes between the two albumin administration groups.
Main Results:
- Early albumin administration resulted in significantly less fluid creep (4.3% vs 56.5%) and shorter hospital stays (p < 0.001).
- The early albumin group also showed reduced need for skin grafts (p=0.032) and debridement (p=0.022).
- Both fluid creep and hospital length of stay were independently associated with infection development (p < 0.05).
Conclusions:
- Early albumin resuscitation in pediatric burn patients improves key clinical outcomes, including reduced fluid creep and shorter hospital stays.
- Fluid creep and prolonged hospital stay are indicators of negative prognosis and are linked to infection.
- This study supports early albumin use as a beneficial strategy in managing burn injuries in children.
Introduction:
Aggressive fluid resuscitation has been extensively discussed after the establishment of fluid creep phenomenon as a morbidity and mortality factor in burn children. Sepsis is currently the leading cause of death in survivors of burn shock.
Objectives:
To evaluate the association between fluid creep and infection in burn children exposed to two different fluid resuscitation strategies with the use of albumin.
Methods:
A cohort of 46 burn children with 15-45% of body surface area (BSA) admitted up to 12 h after the incident were evaluated. Patients from early albumin group (n = 23) received 5% albumin between 8 and 12 h from injury and patients from delayed albumin group (n = 23) received 5% albumin after 24 h. Outcomes analysed were development of fluid creep, length of stay in the hospital, number of surgery procedures and infection until hospital discharge.
Results:
Compared to the delayed group, patients that received early albumin had a shorter length of stay in the hospital (p = 0.007), less fluid creep (4.3% × 56.5%) (p < 0.001), less skin graft procedure (47.8% × 78.3%) (p = 0.032) and less debridement (73.9% × 100%) (p = 0.022). Both length of stay in the hospital and fluid creep arising were associated with infection (p < 0.05).
Conclusion:
Fluid creep, surgery procedures and length of stay in hospital parameters showed better results in burn children treated with early albumin. Fluid creep and length of stay in the hospital were associated with infection, providing a negative prognosis.
Related Concept Videos
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:28Factors Affecting Creep
Further, the water/cement ratio is critical, as a lower ratio increases concrete strength, thus reducing creep. The strength of the...
01:20Infection
The chain begins with pathogens: bacteria, viruses, fungi, prions, or parasites such as protozoa helminths. These can be present on the skin as transient or resident flora, or they can be acquired from the environment. Identifying and treating the type of infection and...
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
01:22Burn Injuries
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...