Transdermal Fluid Loss in Severely Burned Patients

Overview

Journal Ger Med Sci

Specialty General Medicine

Date 2010 Nov 11

PMID 21063470

Citations 5

Authors

Thomas Namdar

Peter L Stollwerck

Felix H Stang

Frank Siemers

Peter Mailander

Thomas Lange

Affiliations

Soon will be listed here.

Abstract

Introduction: The skin protects against fluid and electrolyte loss. Burn injury does affect skin integrity and protection against fluid loss is lost. Thus, a systemic dehydration can be provoked by underestimation of fluid loss through burn wounds.

Purpose: We wanted to quantify transdermal fluid loss in burn wounds.

Method: Retrospective study. 40 patients admitted to a specialized burn unit were analyzed and separated in two groups without (Group A) or with (Group B) hypernatremia. Means of daily infusion-diuresis-ratio (IDR) and the relationship to totally burned surface area (TBSA) were analyzed.

Results: In Group A 25 patients with a mean age of 47 ± 18 years, a mean TBSA of 23 ± 11%, and a mean abbreviated burned severity index (ABSI) score of 6.9 ± 2.1 were summarized. In Group B 15 patients with a mean age of 47 ± 22 years, a mean TBSA of 30 ± 13%, and a mean ABSI score of 8.1 ± 1.7 were included. Statistical analysis of the period from day 3 to day 6 showed a significant higher daily IDR-amount in Group A (Group A vs. Group B: 786 ± 1029 ml vs. -181 ± 1021 ml; p<0.001) and for daily IDR-TBSA-ratio (Group A vs. Group B: 40 ± 41 ml/% vs. -4 ± 36 ml/%; p<0.001).

Conclusions: There is a systemic relevant transdermal fluid loss in burn wounds after severe burn injury. Serum sodium concentration can be used to calculate need of fluid resuscitation for fluid maintenance. There is a need of an established fluid removal strategy to avoid water and electrolyte imbalances.

Citing Articles

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Arabidarrehdor G, Tivay A, Bighamian R, Meador C, Kramer G, Hahn J Burns. 2020; 47(2):371-386.

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Progressive fluid removal can avoid electrolyte disorders in severely burned patients.

Namdar T, Leonard Stollwerck P, Stang F, Kolios G, Lange T, Mailander P Ger Med Sci. 2011; 9:Doc13.

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