Abstract
Individualizing Optimal Fluid Resuscitation in Patients with Major Burns: Emerging Role for Hydrocortisone, Proteinuria and Brain Natriuretic Peptide
Highlights
At the time of severe burn injury, the body responds with a massive inflammatory reaction driven by cytokines which induce the endothelial cells to lose their binding, leading to capillary leakage [5,6]
Capillary leakage with insufficient fluid resuscitation will lead to a low intravascular volume and Brain Natriuretic Peptide (BNP) levels
Proteinuria and BNP levels in combination can be used to judge the extent of capillary leakage immediately after the burn injury
Summary
The paragraphs address recent studies that may be useful for identifying patients with major burns (percentage total body surface area burned 20% or higher, according to the American Burns Associations’ burn severity grading system) who are at risk for excessive capillary leakage, on interventions to reduce capillary leakage and on parameters that might be used to monitor fluid status and to tailor amount of fluids to be supplied. The focus in these paragraphs will be on the emerging role for hydrocortisone, proteinuria and Brain Natriuretic Peptide (BNP) to optimize individual patient’s fluid resuscitation.
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