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The review of literature discusses modern trends of infusion therapy for children and adults in acute period of severe burning injury. The authors used PubMed and Google Scholar to search for the primary terms and the data of own research. The conclusion is that the formulas used for infusion volume calculations often lead to significant fluid of affected person and serious complications. In order to avoid such an overload the authors suggest key points of infusion therapy using invasive monitoring of hemodynamic in children and adults with acute burning traumas.

About the authors

A. U. Lekmanov

The Pirogov Russian National Research Medical University

Author for correspondence.
Email: aulek@rambler.ru
Russian Federation

D. K. Azovsky

Municipal Pediatric Clinical Hospital № 9 named after G.N. Speransky

Email: Dmitry.azovskiy@gmail.com
Russian Federation

S. F. Pilyutik

Municipal Pediatric Clinical Hospital № 9 named after G.N. Speransky

Email: spilyutik@gmail.com
Russian Federation


  1. Bortolani A., Governa M., Barisoni D. Fluid replacement in burned patients // Acta Chir Plast. 1996. Vol. 38. P. 132-136.
  2. Cartotto R. P. Fluid resuscitation of the thermally injured patient // Clin Plastic Surg. 2009. Vol. 36. No 4. Р. 569-581.
  3. Baxter C. Guidelines for fluid resuscitation // J Trauma. 1981. Vol. 21. Suppl. 8. P. 687-689.
  4. Holm C. Resuscitation in shock associated with burns: tradition or evidence-based medicine? // Resuscitation. 2000. Vol. 44. P. 157-164.
  5. Schwartz S. I. Supportive therapy in burn care: consensus summary on fluid resuscitation // J. Trauma. 1979. Vol. 19. Suppl. 11. P. 876-877.
  6. Wolf S. E., Rose J. K., Desai M. H. et al. Mortality determinants in massive pediatric burns: an analysis of 103 children with or 80% TBSA burns, or 70% full-thickness) // Ann. Surg. 1997. Vol. 225. P. 554-565; discussion 565-569
  7. Starling E. H. On the absorption of fluids from the connective tissue spaces // J. Physiol. 1896. Vol. 19. P. 312-326.
  8. Levick J. R., Michel C. C. Microvascular fluid exchange and the revised Starling principle // Cardiovasc. Res. 2010. Vol. 87. P. 198-210.
  9. Chelazzi C., Billa G., Mancinelli P., de Gaudio A. R., Adembri C. Glycocalyx and sepsis-induced alterations in vascular permeability // Crit. Care. 2015. Vol. 19. P. 26.
  10. Rehm M., Bruegger D., Christ F., Conzen P., Thiel M., Jacob M., Chappell D., Stoeckelhuber M., Welsch U., Reichart B., Peter K., Becker B. F. Shedding of the endothelial glycocalyx in patients undergoing major vascular surgery with global and regional ischemia // Circulation. 2007. Vol. 116. P. 1896-1906.
  11. Chappell D., Westphal M., Jacob M. P. The impact of the glycocalyx on microcirculatory oxygen distribution in critical illness // Curr. Opin. Anaesthesiol. 2009. Vol. 22. P. 155-162.
  12. Kamp-Jensen M., Olesen K. L., Bach V., Schütten H. J., Engquist A. Changes in serum electrolyte and atrial natriuretic peptide concentrations, acid-base and haemodynamic status after rapid infusion of isotonic saline and Ringer lactate solution in healthy volunteers // Br. J. Anaest. 1990. Vol. 64. P. 606-610.
  13. Cordemans C., de Laet I., van Regenmortel N. et al. Fluid management in critically ill patients: the role of extravascular lung water, abdominal hypertension, capillary leak and fluid balance // Ann. Int. Care. Vol. 2. Suppl. 1. S1.
  14. Chappell D., Bruegger D., Potzel J., Jacob M., Brettner F., Vogeser M., Conzen P., Becker B. F., Rehm M. Hypervolemia increases release of atrial natriuretic peptide and shedding of the endothelial glycocalyx // Crit. Care. 2014, Oct 13. Vol. 18. No 5.
  15. Underhill F. P. The significance of anhydremia in extensive superficial burns // JAMA. 1930. Vol. 95. No 12. P. 852-857.
  16. Cope O., Moore F. D. The Redistribution of Body Water and the Fluid Therapy of the Burned Patient // Ann. Surg. 1947, December. Vol. 126. No 6. P. 1010-1045.
  17. Evans E. I., Purnell O. J., Robinett P. W. et al. Fluid and electrolyte requirements in severe burns // Ann. Surg. 1952, June. Vol. 135. No 6. P. 804-815.
  18. Haynes B. W. Jr., Martin M. M., Purnell O. J. Fluid, colloid and electrolyte requirements in severe burns. I. An analysis of colloid therapy in 158 cases using the Evans formula // Ann. Surg. 1955, Oct. Vol. 142. No 4. P. 674-679.
  19. Baxter C. R., Shires T. Physiological response to crystalloid resuscitation of severe burns // Ann. NY Acad Sci. 1968, Aug 14. Vol. 150. No 3. P. 874-894.
  20. Лекманов А. У., Астамиров М. К., Пилютик С. Ф. Современная интенсивная терапия тяжелой термической травмы у детей // Неотложная медицина. 2011. № 2. С. 3-10.
  21. Cartotto R., Zhou A. Fluid creep: the pendulum hasn’t swung back yet! // J. Burn. Care Res. 2010, Jul-Aug. Vol. 31. No 4. P. 551-558.
  22. Faraklas I., Cochran A., Saffle J. Review of a fluid resuscitation protocol: fluid creep is not due to nursing error // J. Burn. Care Res. 2012, Jan-Feb. Vol. 33. No 1. P. 74-83.
  23. Saffle J. I. The phenomenon of «fluid creep» in acute burn resuscitation // J. Burn Care Res. 2007, May-Jun. Vol. 28. No 3. P. 382-395.
  24. Shah A., Kramer G. C., Grady J. J. et al. Meta-Analysis of Fluid Requirements for Burn Injury 1980-2002 // J. Burn Care Rehabil. 2003. Vol. 24. S118.
  25. Strang S. G., van Lieshout E. M., Breederveld R. S. A systematic review on intra-abdominal pressure in severely burned patients // Burns. 2014, Feb. Vol. 40. No 1. P. 9-16.
  26. Kirkpatrick A. W., Roberts D. J., de Waele J. et al. Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome // Int. Care Med. 2013, Jul. Vol. 39. No 7. P. 1190-1206.
  27. Астамиров М. К., Лекманов А. У., Пилютик С. Ф., Табакина Т. Е. Ошибки терапии тяжелой ожоговой травмы у детей на этапе неспециализированной помощи // Вестник анестезиологии и реаниматологии. 2013. № 3. С. 40-47.
  28. Malbrain M. L., Roberts D. J., Sugrue M. et al. The polycompartment syndrome: a concise state-of-the-art review // Anaesth. Int. Ther. 2014, Nov-Dec. Vol. 46. No 5. P. 433-450.
  29. Pruitt B. A. Jr. Protection from excessive resuscitation: pushing the pendulum back // J. Trauma. 2000, Sep. Vol. 49. No 3. P. 567-568.
  30. Sullivan S. R., Ahmadi A. J., Singh C. N. et al. Elevated orbital pressure: another untoward effect of massive resuscitation after burn injury // J Trauma. 2006, Jan. Vol. 60. No 1. P. 72-76.
  31. Ball C. G., Kirkpatrick A. W., Karmali S. et al. Tertiary abdominal compartment syndrome in the burn injured patient // J. Trauma, 2006, Nov. Vol. 61. No 5. P. 1271-1273.
  32. Lawrence A., Faraklas I, Watkins H et al. Colloid administration normalizes resuscitation ratio and ameliorates «fluid creep» // J. Burn Care Res. 2010, Jan-Feb. Vol. 31. No 1. P. 40-47.
  33. Kim D. E., Phillips T. M., Jeng J. C., Rizzo A. G, Roth R. T., Stanford J. L., Jablonski K. A., Jordan M. H. Microvascular assessment of burn depth conversion during varying resuscitation conditions // J. Burn Care Rehabil. 2001. Vol. 22. P. 406-416.
  34. Arlati S., Storti E., Pradella V., Bucci L., Vitolo A., Pulici M. Decreased fluid volume to reduce organ damage: a new approach to burn shock resuscitation? A preliminary study // Resuscitation. 2007. Vol. 72. P. 371-378.
  35. Карваял X. Ф., Паркс Д. X. Ожоги у детей / пер. с англ. И. И. Юрасова. - М.: Медицина, 1990. - 510 с.
  36. Dries D. J., Waxman K. Adequate resuscitation of burn patients may not be measured by urine output and vital signs // Crit. Care Med. 1991, Mar. Vol. 19. No 3. P. 327-329.
  37. Tokarik M., Sjöberg F., Balik M., Pafcuga I., Broz L. Fluid therapy LiDCO controlled trial-optimization of volume resuscitation of extensively burned patients through noninvasive continuous real-time hemodynamic monitoring LiDCO // J. Burn Care Res. 2013, Sep-Oct. Vol. 34. No 5. P. 537-542.
  38. Paratz J. D., Stockton K., Paratz E. D., Blot S., Muller M., Lipman J., Boots R. J. Burn resuscitation-hourly urine output versus alternative endpoints: a systematic review // Shock. 2014, Oct. Vol. 42. No 4. P. 295-306.
  39. Marik P. E., Rodrigo C. Does the central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some common sense // Crit. Care Med. 2013. V. 41, Is. 7. P. 1774-1781.
  40. Cessoni M., Parsons A. K., Rhodes A. What is fluid challenge? // Currentopinionin CC. 2011. Vol. 17. P. 290-295.
  41. Payen D. Prediction of fluid challenge effect: filling pressure when left ventricular function is abnormal, diastolic volume when left ventricular function is normal // Crit. Care. 2011. Vol. 15. P. 139.
  42. Csontos C., Foldi V., Fischer T. et al. Arterial thermodilution in burn patients suggests a more rapid fluid administration during early resuscitation // Acta Anaesth. Scand. 2008, Jul. Vol. 52. No 6. P. 742-749.
  43. Sánchez M., García-de-Lorenzo A., Herrero E., Lopez T., Galvan B., Asensio M., Cachafeiro L., Casado C. A protocol for resuscitation of severe burn patients guided by transpulmonary thermodilution and lactate levels: a 3-year prospective cohort study // Crit. Care. 2013, Aug 15. Vol. 17. No 4. P. 176.
  44. Holm C., Melcer B., Hörbrand F., Wörl H., von Donnersmarck G. H., Mühlbauer W. Intrathoracic blood volume as an end point in resuscitation of the severely burned: an observational study of 24 patients // J. Trauma. 2000, Apr. Vol. 48. No 4. P. 728-734.
  45. Лекманов А. У., Азовский Д. К., Пилютик С. Ф., Гегуева Е. Н. Коррекция гемодинамики у детей с тяжелыми травматическими повреждениями на основе транспульмональной термодилюции // Анестезиология и реаниматология. 2011. № 1. С. 32-36.
  46. Branski L. K., Herndon D. N., Byrd J. F. et al. Transpulmonary thermodilution for hemodynamic measurements in severely burned children // Crit. Care. 2011. Vol. 15. No 2. R118.
  47. Лекманов А. У. Некоторые противоречия клинического применения Surviving Sepsis Campaign - 2012 // Вестник анестезиологии и реаниматологии. 2014. № 3. С. 65-73.
  48. Awad S. P., Allison S. P., Lobo D. N. The history of 0.9% saline // Clin. Nutr. 2008, Apr. Vol. 27. No 2. P. 179-188.
  49. Stephens R. C., Mythen M. G. Saline-based fluids can cause a significant acidosis that may be clinically relevant // Crit. Care Med. 2000, Sep. Vol. 28. No 9. P. 3375-3377.
  50. van Regenmortel N., Jorens P. G., Malbrain M. L. Fluid management before, during and after elective surgery // Curr. Opin. Crit. Care. 2014, Aug. Vol. 20. No 4. P. 390-395.
  51. McDermid R. C., Raghunathan K., Romanovsky A. et al. Controversies in fluid therapy: Type, dose and toxicity // World J. Crit. Care Med. 2014, Feb 4. Vol. 3. No 1. P. 24-33.
  52. Young J. B., Utter G. H., Schermer C. R. et al. Saline versus Plasma-Lyte A in initial resuscitation of trauma patients: a randomized trial // Ann. Surg. 2014, Feb. Vol. 259. No 2. P. 255-262.
  53. Baxter C. R. Fluid volume and electrolyte changes of the early postburn period // Clin. Plast Surg. 1974, Oct. Vol. 1. No 4. P. 693-703.
  54. Myburgh J. A., Finfer S., Bellomo R. et al. Hydroxyethyl starch or saline for fluid resuscitation in intensive care // New Engl. J. Med. 2012, Nov 15. Vol. 367. No 20. P. 1901-1911.
  55. Perner A., Haase N., Guttormsen A. B. et al. Hydroxyethyl starch 130/0.42 versus Ringer’s acetate in severe sepsis // New Engl. J. Med. 2012, Jul 12. Vol. 367. No 2. P. 124-134.
  56. Guidet B., Martinet O., Boulain T. et al. Assessment of hemodynamic efficacy and safety of 6% hydroxyethylstarch 130/0.4 vs. 0.9% NaCl fluid replacement in patients with severe sepsis: the CRYSTMAS study // Crit. Care. 2012, May 24. Vol. 16. No 3. P. 94.
  57. Béchir M., Puhan M. A., Fasshauer M., Schuepbach R. A., Stocker R., Neff Th. A. Early fluid resuscitation with hydroxyethyl starch 130/0.4 (6%) in severe burn injury: a randomized, controlled, double-blind clinical trial // Crit. Care. 2013. Vol. 17. P. 299.
  58. Vlachou E., Gosling P., Moiemen N. S. Hydroxyethylstarch supplementation in burn resuscitation - a prospective randomised controlled trial // Burns. 2010, Nov. Vol. 36. No 7. P. 984-991.
  59. Лекманов А. У. Рациональная объемозамещающая терапия у детей // Российский вестник детской хирургии, анестезиологии и реаниматологии. 2011. № 3. С. 36-42.
  60. Coriat P., Guidet B., de Hert S. et al. Counter statement to open letter to the Executive Director of the European Medicines Agency concerning the licensing of hydroxyethyl starch solutions for fluid resuscitation // Br. J. Anaesth. 2014, Jul. Vol. 113. No 1. P. 194-195.
  61. Cochran A., Morris S. E., Edelman L. S. et al. Burn patient characteristics and outcomes following resuscitation with albumin // Burns. 2007, Feb. Vol. 33. No 1. P. 25-30.
  62. Park S. H., Hemmila M. R., Wahl W. L. Early albumin use improves mortality in difficult to resuscitate burn patients // J. Trauma Acute Care Surg. 2012, Nov. Vol. 73. No 5. P. 1294-1297.
  63. Jacob M., Paul O., Mehringer L., Chappell D., Rehm M., Welsch U. et al. Albumin augmentation improves condition of guinea pig hearts after 4 hr of cold ischemia // Transplantation. 2009. Vol. 87. P. 956-965.
  64. Cochran A., Morris S. E., Edelman L. S. et al. Burn patient characteristics and outcomes following resuscitation with albumin // Burns. 2007, Feb. Vol. 33. No 1. P. 25-30.
  65. Cartotto R., Callum J. A review of the use of human albumin in burn patients // J. Burn Care Res. 2012, Nov-Dec. Vol. 33. No 6. P. 702-717.
  66. Duchesne J. C., Kaplan L. J., Balogh Z. J. et al. Role of permissive hypotension, hypertonic resuscitation and the global increased permeability syndrome in patients with severe hemorrhage: adjuncts to damage control resuscitation to prevent intra-abdominal hypertension // Anaesth. Int. Ther. 2015. Vol. 47. No 2. P. 143-155.
  67. Monafo W. W., Chuntrasakul C., Ayvazian V. H. Hypertonic sodium solutions in the treatment of burn shock // Am. J. Surg. 1973, Dec. Vol. 126. No 6. P. 778-783.
  68. Moylan J. A. Jr., Reckler J. M., Mason A. D. Jr. Resuscitation with hypertonic lactate saline in thermal injury // Am. J. Surg. 1973, May. Vol. 125. No 5. P. 580-584.
  69. Berger M. M., Yok Ai Que. A protocol guided by transpulmonary thermodilution and lactate levels for resuscitation of patients with severe burns // Crit. Care. 2013, Vol. 17. P. 195.
  70. Zhang D., Chai J. Current situation of research and application of Parkland formula in burn resuscitation // Zhonghua Shao Shang Za Zhi. 2015, Jun. Vol. 31. No 3. P. 235-237.

Copyright (c) 2016 Lekmanov A.U., Azovsky D.K., Pilyutik S.F.

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