An overview on fluid resuscitation and resuscitation endpoints in burns: Past, present and future. Part 1 — historical background, resuscitation fluid and adjunctive treatment
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An improved understanding of burn shock pathophysiology and subsequent development of fluid resuscitation strategies has led to dramatic outcome improvements in burn care during the 20th century. While organ hypoperfusion caused by inadequate resuscitation has become rare in clinical practice, there is growing concern that increased morbidity and mortality related to over-resuscitation is occurring more frequently in burn care. In order to reduce complications related to this concept of "fluid creep", such as respiratory failure and compartment syndromes, efforts should be made to resuscitate with the least amount of fluid in order to provide adequate organ perfusion. In this first part of a concise review, historic and current evidence regarding the available fluids is discussed, as well as some adjunctive treatments modulating the inflammatory response. In the second part, special reference will be made to the role of abdominal hypertension in burn care and the endpoints used to guide fluid resuscitation will be discussed. Finally, as urine output has been recognized as a poor resuscitation target, a resuscitation protocol is suggested in part two which includes new targets and endpoints that can be obtained with modern, less invasive hemodynamic monitoring devices.
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Other studies found that the use of high-dose vitamin C in patients with severe burns resulted in less positive fluid balance and less secondary abdominal hypertension.
“Other studies found that the use of high-dose vitamin C in patients with severe burns resulted in less positive fluid balance and less secondary abdominal hypertension [84].”
From Nutrition in Sepsis: A Bench-to-Bedside Review. (2020) · cites this paper as [84]
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Critical Care in the Severely Burned
Culnan, D. M., Sherman, W. C., Chung, K. K., & Wolf, S. E. (2018) · Elsevier eBooks · doi:10.1016/b978-0-323-47661-4.00032-0 · Cited by 11 · see citing works
Vitamin C in burns, sepsis, and trauma
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The Potential of Arterial Pulse Wave Analysis in Burn Resuscitation: A Pilot In Vivo Study
Arabidarrehdor, G., Kao, Y.-M., Oliver, M. A., Parajuli, B., Carney, B. C., Keyloun, J. W., Moffatt, L. T., Shupp, J. W., Hahn, J., & Burmeister, D. M. (2022) · Journal of Burn Care & Research · doi:10.1093/jbcr/irac097 · Cited by 8 · see citing works
Association between fluid creep and infection in burned children: A cohort study
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Update burn surgery: overview of current multidisciplinary treatment concepts
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Less Is More—Revisiting Burn Resuscitation*
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A sirs-based automated alarm system for the diagnosis of sepsis after burn injury.
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Self-citationInfluences of Macrohemodynamic Conditions on Systemic Microhemodynamic Changes in Burns
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Modern views on infusion of crystalloids in intensive care
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Fluid Management in Major Burns
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Terms and Definitions of Fluid Therapy
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Self-citationAnatomy and Physiology of the Abdominal Compartment
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Fluid Therapy for Critically Ill Burn Patients
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Critical care in the severely burned: Organ support and management of complications
Culnan, D. M., Sherman, W. C., Chung, K. K., Sjöberg, F., & Wolf, S. E. (2026) · Elsevier eBooks · doi:10.1016/b978-0-323-88389-4.00035-x
- Authors
- Peeters, Y., Vandervelden, S., Wise, R., & Malbrain, M. L. N. G.
- Affiliations
- Ziekenhuisnetwerk Antwerpen Stuivenberg (BE)
- Venue
- Anestezjologia Intensywna Terapia
- Publisher
- Termedia Sp. z.o.o.
- Published
- 2015-12-29
- Volume
- 47
- Issue
- J
- Pages
- 6-14
- ISSN
- 1642-5758 (ISSN-L)
- 1731-2531
- OpenAlex
- W2161670539
- Cited by
- 33
- References
- 79
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 8 · 2022: 2 · 2021: 2 · 2020: 5 · 2019: 1 · 2018: 3 · 2017: 3 · 2016: 4
- FWCI
- 2.62
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-sa
- Locations
- Anaesthesiology Intensive Therapy (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- Via Medica Journals (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Burn Injury Management and Outcomes
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Keywords
- burn shock, fluid resuscitation, burn resuscitation, fluid creep, over-resuscitation, resuscitation endpoints, organ hypoperfusion, abdominal hypertension, urine output, hemodynamic monitoring, adjunctive therapy, inflammation modulation, compartment syndrome, respiratory failure
- MeSH terms
- Crystalloid Solutions, Albumins, Ascorbic Acid, Burns, Colloids, Fluid Therapy, Humans, Isotonic Solutions, Plasmapheresis, Resuscitation, Endpoint Determination
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