Optimum Composition of Resuscitation Fluids,
WASHINGTON UNIV SEATTLE SCHOOL OF MEDICINE
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The fluid loads required for resuscitation in burn patients can be significantly decreased by either the use of isotonic, iso-oncotic albumin-crystalloid solutions or by simply increasing the sodium content of the administered crystalloid. However, evidence has appeared that persistent effects of albumin on pulmonary, renal and hematologic function may be present which delay excretion of the sodium and water loads administered for resuscitation, prolong edema in both normal and injured tissue and - perhaps - increase mortality. In crystalloid-resuscitated patients, survival from the burn illness correlates inversely with the magnitude of the fluid loads administered. Late adverse effects of resuscitation with appreciable amounts of hypertonic sodium solutions, which decreases the fluid requirement, but which also necessitates close clinical monitoring, have not been identified. The effectiveness of fluid resuscitation should be evaluated in terms of the whole burn illness and not judged solely by its ability to preserve life during the shock phase.