Abstract
‘Permissive hypovolaemia’ fluid regimes in adult burn care are suggested to improve outcomes. Effects in paediatric burn care are less well understood.
In a retrospective audit, outcomes of children from the South West Children's Burn Centre (SWCBC) less than 16 years of age with scalds of 10–20% burn surface area (BSA) managed with a reduced volume fluid resuscitation regime (post-2007) were compared to (a) an historical local protocol (pre-2007) and (b) current regimes in burn services across England and Wales (E&W). Outcomes included length of stay per percent burn surface area (LOS/%BSA), skin graft requirement and re-admission rates.
92 SWCBC patients and 475 patients treated in 15 other E&W burn services were included. Median LOS/%BSA for patients managed with the reduced fluid regime was 0.27 days: significantly less than pre-2007 and other E&W burn services (0.54 days, 0.50 days, p < 0.001). Skin grafting to achieve healing reduced post-2007 compared to pre-2007 and remains comparable with other E&W services. Re-admission rates were comparable between all groups.
A reduced fluid regime has significantly shortened LOS/%BSA without compromising burn depth as measured by skin grafting to achieve healing. A prospective trial comparing permissive hypovolaemia to current regimes for moderate paediatric scald injuries would help clarify.
Original language | English |
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Pages (from-to) | 1581-1586 |
Number of pages | 6 |
Journal | Burns |
Volume | 40 |
Issue number | 8 |
Early online date | 30 Apr 2014 |
DOIs | |
Publication status | Published - Dec 2014 |
Keywords
- Permissive hypovolaemia
- Paediatrics
- Scalds
- Burn care
- Fluid resuscitation