Influences of different resuscitation regimens on acute early weight gain in extensively burned patients

Abstract

Dissatisfaction with the massive weight gain that commonly followed crystalloid resuscitation of extensively burned patients dictated the need for a study to determine if acute weight gain could be minimized with an alternative form of resuscitation. Three groups of ten patients each with statistically similar age and burn size (mean BSA 46 per cent) were resuscitated with lactated Ringer's solution (LR), hypertonic saline solution (HPT), or fresh frozen plasma (FFP). The volume of infused fluid and the patient weight gain were measured over the first 48 h of treatment. The mean urine output of the three groups was comparable (P > 0.05). The volume of infused resuscitation fluid to maintain urine output was a mean of 4.8 ml/kg/per cent BSA in the LR group, 3.16 in the HPT group and 2.68 in the FFP group. The difference in infusion rate between the FFP group and the LR group was statistically significant (P < 0.01). All patients gained weight with resuscitation. The median percentage weight gain at the end of the first day of treatment was 10.69 per cent in the LR group, 7.88 per cent in the HPT group and 2.38 per cent in the FFP group. Weight gain at the end of the second day of treatment was 13.9 per cent in the LR group, 11.99 per cent in the HPT group, and 4.37 per cent in the FFP group. The differences between FFP, HPT and LR groups were statistically significant (P < 0.01). In our study the use of fresh frozen plasma for resuscitation of extensively burned patients has been associated with minimal weight gain and minimal oedema. We believe that fresh frozen plasma resuscitation is an attractive alternative to crystalloid infusion and that further comparative studies should be performed.