The First 24 Hours: Burn Shock Resuscitation and Early Complications

Shawn Tejiram; Stephen P Tranchina; Taryn E Travis; Jeffrey W Shupp

doi:10.1016/j.suc.2023.02.002

The First 24 Hours: Burn Shock Resuscitation and Early Complications

Surg Clin North Am. 2023 Jun;103(3):403-413. doi: 10.1016/j.suc.2023.02.002. Epub 2023 Mar 21.

Authors

Shawn Tejiram¹, Stephen P Tranchina², Taryn E Travis³, Jeffrey W Shupp⁴

Affiliations

¹ The Burn Center, MedStar Washington Hospital Center, 110 Irving Street, Northwest Suite 3B-55, Washington, DC 20010, USA; Department of Surgery, Georgetown University School of Medicine, 3900 Reservoir Road NW, Washington, DC 20007, USA.
² Georgetown University School, 3900 Reservoir Road NW, Washington, DC 20007, USA.
³ The Burn Center, MedStar Washington Hospital Center, 110 Irving Street, Northwest Suite 3B-55, Washington, DC 20010, USA; Department of Surgery, Georgetown University School of Medicine, 3900 Reservoir Road NW, Washington, DC 20007, USA; Department of Plastic and Reconstructive Surgery, Georgetown University School of Medicine, 3900 Reservoir Road NW, Washington, DC 20007, USA.
⁴ The Burn Center, MedStar Washington Hospital Center, 110 Irving Street, Northwest Suite 3B-55, Washington, DC 20010, USA; Department of Surgery, Georgetown University School of Medicine, 3900 Reservoir Road NW, Washington, DC 20007, USA; Department of Plastic and Reconstructive Surgery, Georgetown University School of Medicine, 3900 Reservoir Road NW, Washington, DC 20007, USA; Department of Biochemistry and Molecular & Cellular Biology, Georgetown University Medical Center, 37th and O Street, Northwest, Washington, DC 20057, USA. Electronic address: Jeffrey.W.Shupp@medstar.net.

PMID: 37149377
DOI: 10.1016/j.suc.2023.02.002

Abstract

Resuscitation is required for the management of patients with severe thermal injury. Some of the initial pathophysiologic events following burn injury include an exaggerated inflammatory state, injury to the endothelium, and increased capillary permeability, which all culminate in shock. Understanding these processes is critical to the effective management of patients with burn injuries. Formulas predicting fluid requirements during burn resuscitation have evolved over the past century in response to clinical experience and research efforts. Modern resuscitation features individualized fluid titration and monitoring along with colloid-based adjuncts. Despite these developments, complications from over-resuscitation still occur.

Keywords: Burn; Colloid; Compartment syndrome; Fluid creep; Resuscitation.

Publication types

Review

MeSH terms

Burns* / complications
Burns* / therapy
Fluid Therapy / adverse effects
Humans
Resuscitation / adverse effects
Shock* / complications
Shock* / therapy