Resuscitation Strategies for Burn Injuries Sustained in Austere Environments to Improve Renal Perfusion and Function
Technical Report,30 Sep 2018,29 Sep 2019
GENEVA FOUNDATION TACOMA WA TACOMA United States
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Our overall hypothesis is that oral or intravenous resuscitation results in distinct improvements in burn-induced SIRS and AKI. Specifically, while oral resuscitation i.e., drinking helps in reducing SIRS, MOD and AKI post-burn injury, we predict it will not be as effective as the gold standard i.v. fluid resuscitation which may relate to fluid volume requirements that cannot be met orally. Moreover, we hypothesize that i.v. blood products e.g., fresh frozen plasma will improve organ perfusion and outcomes when compared to crystalloids, and thus reduce total fluid requirements. Resuscitation strategies will vary in ameliorating burn induced renal perfusion and dysfunction because of a differential effect on circulating cytokines and granulocytes. Subsequently, markers and byproducts of oxidative stress will increase as renal perfusion decreases. Information from the studies described in this proposal will elucidate what effect low volume post-burn resuscitation strategies have on the mechanisms of oxidative stress and systemic and local inflammation. This will not only provide information on the ensuing SIRS, MOD, and AKI, but also allow for future testing of therapies to modulate these mechanisms. The ultimate goal is to improve outcomes after extensive burn in austere environments where large volumes of fluid are not available and the casualty is delayed in transport to a treatment facility.
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