Change search
ReferencesLink to record
Permanent link

Direct link
Hemodynamic changes during resuscitation after burns using the Parkland formula
Hälsouniversitetet, Linköping University.
Show others and affiliations
2009 (English)In: Journal of Trauma, ISSN 0022-5282, E-ISSN 1529-8809, Vol. 66, no 2, 329-336 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The Parkland formula (2-4 mL/kg/burned area of total body surface area %) with urine output and mean arterial pressure (MAP) as endpoints for the fluid resuscitation in burns is recommended all over the world. There has recently been a discussion on whether central circulatory endpoints should be used instead, and also whether volumes of fluid should be larger. Despite this, there are few central hemodynamic data available in the literature about the results when the formula is used correctly.

METHODS: Ten burned patients, admitted to our unit early, and with a burned area of >20% of total body surface area were investigated at 12, 24, and 36 hours after injury. Using transesophageal echocardiography, pulmonary artery catheterization, and transpulmonary thermodilution to monitor them, we evaluated the cardiovascular coupling when urinary output and MAP were used as endpoints.

RESULTS: Oxygen transport variables, heart rate, MAP, and left ventricular fractional area, did not change significantly during fluid resuscitation. Left ventricular end-systolic and end-diastolic area and global end-diastolic volume index increased from subnormal values at 12 hours to normal ranges at 24 hours after the burn. Extravascular lung water: intrathoracal blood volume ratio was increased 12 hours after the burn.

CONCLUSIONS: Preload variables, global systolic function, and oxygen transport recorded simultaneously by three separate methods showed no need to increase the total fluid volume within 36 hours of a major burn. Early (12 hours) signs of central circulatory hypovolemia, however, support more rapid infusion of fluid at the beginning of treatment.

Place, publisher, year, edition, pages
2009. Vol. 66, no 2, 329-336 p.
Keyword [en]
Cardiovascular coupling, Echocardiography, Hemodynamic monitoring, Fractional area change, Global end-diastolic volume
National Category
Clinical Medicine
URN: urn:nbn:se:kth:diva-85558DOI: 10.1097/TA.0b013e318165c822ISI: 000263442800006PubMedID: 19204504OAI: diva2:500030
QC 20120214Available from: 2012-02-13 Created: 2012-02-13 Last updated: 2012-02-14Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Janerot-Sjoberg, Birgitta
By organisation
Medical Engineering
In the same journal
Journal of Trauma
Clinical Medicine

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 43 hits
ReferencesLink to record
Permanent link

Direct link