BALBUMIN: Encuesta sobre el uso de la albúmina en la reanimación del paciente gran quemado adulto

Abstract

IntroductionIn the resuscitation of the severely burned patient (SBP) the aim is the correct replacement of intravascular volume to guarantee tissue perfusion, but the current levels of evidence do not make some aspects clear, such as the choice of fluid therapy, monitoring and the use of albumin. This has led to conflict among the physicians who attend to these patients. ObjectiveTo determine how the initial resuscitation of the SBP is carried out, and specifically, the use of albumin in the reference units of the Spanish territory (CSUR). MethodsA survey was conducted by e-mail to CSUR staff with questions about epidemiology, initial resuscitation, and use of albumin. ResultsThe majority (86%, 6/7) of the CSUR units have specific equipment and protocols to perform the initial resuscitation of the SBP. Resuscitation is based on the Parkland formula in 43% (3/7), the rest (4/7) combine the Parkland formula and therapeutic-guided resuscitation by transpulmonary thermodilution. Ringer lactate is the fluid of choice in 71% (5/7) of the units, although the Ringer acetate solution is used in 29% (2/7). The large majority of units (86%, 6/7) use albumin according to their specific protocol, as an initial replacement colloid. ConclusionsThe results of this survey have allowed us to know the current situation on the initial resuscitation and the use of albumin in the SBP in the CSUR, detecting new trends and points of conflict in this regard.