BACKGROUND: Two years ago the authors began to use Swan-Ganz catheters to generate more complex hemodynamic data as a better guide to resuscitation of burns. This study uses the information to identify differences between survivors and nonsurvivors. PATIENTS AND METHODS: Fifty-three consecutive patients with major burns were treated using Swan-Ganz-generated data. Additional information was collected, including demographics, intake and output, medications, and arterial blood gas (including calculated oxygen consumption). Statistical analysis incorporated adjustments for autocorrelation. RESULTS: The patients included 38 men and 15 women, averaged 43.7 years of age, and had a mean burn size of 40%. Thirteen patients suffered severe inhalation injury. Data collected hourly over 3 days were collapsed across 6-hour observation periods. Mean values, when plotted across time, discriminated the 37 survivors from the 16 nonsurvivors. Poor response to resuscitation as evidenced by increased use of colloid fluid and cardiotonic drugs plus failure to maximize oxygen consumption were associated with nonsurvival. CONCLUSIONS: Unsustained or inadequate response to hyperdynamic resuscitation of burns was associated with nonsurvival.
BACKGROUND: Two years ago the authors began to use Swan-Ganz catheters to generate more complex hemodynamic data as a better guide to resuscitation of burns. This study uses the information to identify differences between survivors and nonsurvivors. PATIENTS AND METHODS: Fifty-three consecutive patients with major burns were treated using Swan-Ganz-generated data. Additional information was collected, including demographics, intake and output, medications, and arterial blood gas (including calculated oxygen consumption). Statistical analysis incorporated adjustments for autocorrelation. RESULTS: The patients included 38 men and 15 women, averaged 43.7 years of age, and had a mean burn size of 40%. Thirteen patients suffered severe inhalation injury. Data collected hourly over 3 days were collapsed across 6-hour observation periods. Mean values, when plotted across time, discriminated the 37 survivors from the 16 nonsurvivors. Poor response to resuscitation as evidenced by increased use of colloid fluid and cardiotonic drugs plus failure to maximize oxygen consumption were associated with nonsurvival. CONCLUSIONS: Unsustained or inadequate response to hyperdynamic resuscitation of burns was associated with nonsurvival.
Authors: Derek M Culnan; Kelley Farner; Genevieve H Bitz; Karel D Capek; Yiji Tu; Carlos Jimenez; William C Lineaweaver Journal: Ann Plast Surg Date: 2018-03 Impact factor: 1.539
Authors: Sabri Soussi; Benjamin Deniau; Axelle Ferry; Charlotte Levé; Mourad Benyamina; Véronique Maurel; Maïté Chaussard; Brigitte Le Cam; Alice Blet; Maurice Mimoun; Jêrome Lambert; Marc Chaouat; Alexandre Mebazaa; Matthieu Legrand Journal: Ann Intensive Care Date: 2016-09-13 Impact factor: 6.925