Impact of reduced resuscitation fluid on outcomes of children with 10–20% body surface area scalds

Tim J Walker, D Urriza Rodriguez, Karen Coy, Linda Hollen, Rosemary Greenwood, Amber Young

Research output: Contribution to journalArticle (Academic Journal)

10 Citations (Scopus)
252 Downloads (Pure)

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 languageEnglish
Pages (from-to)1581-1586
Number of pages6
JournalBurns
Volume40
Issue number8
Early online date30 Apr 2014
DOIs
Publication statusPublished - Dec 2014

Keywords

  • Permissive hypovolaemia
  • Paediatrics
  • Scalds
  • Burn care
  • Fluid resuscitation

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