A New Resuscitation Formula Based on Burn Index Provides More Reliable Prediction for Fluid Requirement in Adult Major Burn Patients
A New Resuscitation Formula Based on Burn Index Provides More Reliable Prediction for Fluid Requirement in Adult Major Burn Patients
复制标题
基于烧伤指数的新复苏公式为成人严重烧伤患者的液体需求提供更可靠的预测
DOI：
10.1093/jbcr/irab013
复制
发表时间：
2021-01-23
影响因子：
1.4
通讯作者：
Luo, Gaoxing
中科院分区：
文献类型：
--
作者：
Tan, Jianglin;Zhou, Junyi;Luo, Gaoxing
第三军医大学（TMMU）配方在我国液体复苏中应用广泛。然而，在具有高比例全层烧伤创面的大面积烧伤患者中，实际容量需求通常超过TMMU公式提供的预测。这项回顾性研究纳入了149名成年重度烧伤患者（>= 40%TBSA），这些患者于2014年至2020年入住西南医院烧伤科，并根据TMMU方案接受了适当的液体复苏。将烧伤后48小时内的实际输注量与TMMU公式估计的输注量进行比较。通过多元线性回归分析，建立了一个新的液体体积预测公式。伤后第1、2个24小时的平均液体需要量分别为2.35 ml/kg/% TBSA和1.75 ml/kg/% TBSA。TMMU公式低估了液体需要量，其预测准确率分别为54.1%和25.8%的第一和第二个24小时。全层烧伤创面的比例与烧伤后液体的需要量有关。一个修订的多因素公式组成的烧伤指数，体重，吸入性损伤。采用修正后的公式，复苏液量的预测信度在第一和第二个24小时分别提高到65.3%和61.1%。TMMU公式在预测大面积烧伤患者的液体需求方面显示出较低的准确性。根据TMMU方案，提出了一个基于烧伤指数的修正公式，以更好地指导大面积烧伤患者的主动液体复苏。
The Third Military Medical University (TMMU) formula is widely used in fluid resuscitation in China. However, the actual volume needs usually exceed the prediction provided by the TMMU formula in major burn patients with a high proportion of full-thickness burn wounds. This retrospective study included 149 adult major burn patients (>= 40% TBSA) who were admitted to the Burn Department, Southwest Hospital from 2014 to 2020 and received appropriate fluid resuscitation by the TMMU protocol. The actual volume infused in the first 48 hours postburn was compared to the estimation by the TMMU formula. A new fluid volume prediction formula was developed by multivariate linear regression analysis. The mean fluid requirements were 2.35 ml/kg/% TBSA and 1.75 ml/kg/% TBSA in the first and second 24 hours postburn, respectively. The TMMU formula underestimated the fluid requirement, and its prediction accuracy was 54.1% and 25.8% for the first and second 24 hours, respectively. The proportion of full-thickness burn wound was found to be associated with the fluid requirements postburn. A revised multifactorial formula consisting of the burn index, body weight, and inhalation injury was developed. Using the revised formula, the prediction reliability of resuscitation fluid volume improved to 65.3% and 61.1% in the first and second 24 hours, respectively. The TMMU formula showed low accuracy in predicting fluid requirements among major burn patients. A revised formula based on burn index was developed to provide better guidance for initiative fluid resuscitation for major burns by the TMMU protocol.