美国烧伤协会临床实践指南关于烧伤休克复苏的指南
Robert Cartotto1, Laura S Johnson2, Alisa Savetamal3
1Department of Surgery, Ross Tilley Burn Centre, Sunnybrook Heath Sciences Centre, University of Toronto, Canada.
概括
这份针对烧伤患者的临床实践指南建议在初始液体复苏时使用2mL/kg/% TBSA. 考虑大烧伤的人类白蛋白,以减少液体体积并改善尿液输出.
科学领域:
- 医学科学 医学科学 医学科学
- 创伤护理 创伤护理
- 燃烧管理 燃烧管理
背景情况:
- 在燃烧后的前48小时,急性液体复苏至关重要.
- 需要针对成年烧伤患者的指导方针,烧伤总体表面积 (%TBSA) ≥20%.
研究的目的:
- 为严重烧伤患者提供基于证据的急性液体复苏建议.
- 为临床医生提供最佳流体管理策略的指导,以改善患者的治疗结果.
主要方法:
- 开发了PICO问题,用于系统的文献搜索.
- 从5978个最初的标题中,批评审查了24项研究.
- 组建了一个调查小组来评估证据质量.
主要成果:
- 建议以2mL/kg/%的TBSA燃烧开始复苏,以减少液体体积.
- 建议考虑大烧伤的人类白蛋白溶液,以减少复苏体积并增加尿液输出.
- 在复苏期间建议选择性监测腹腔内和眼内压力.
结论:
- 液体复苏策略应侧重于减少整体液体的使用.
- 专的使用和特定的监测参数是燃烧冲击管理的关键考虑因素.
- 需要进一步的研究,以制定有关死亡结果的建议.
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