Warner P, Connolly J P, Gibran N S, Heimbach D M, Engrav L H
Department of Surgery, University of Washington, Seattle, Washington, USA.
J Burn Care Rehabil. 2003 Sep-Oct;24(5):275-8. doi: 10.1097/01.BCR.0000085855.14964.01.
Early aggressive fluid resuscitation has significantly decreased the morbidity and mortality associated with volume losses from large burns. Although most patients are adequately resuscitated using the Parkland formula, we noted increased fluid requirements for shock resuscitation in patients involved in methamphetamine laboratory explosions. Because predominant users are young healthy individuals in their 20s and 30s, we had not anticipated burn shock resuscitation failures in this patient group. We reviewed our experience with burn patients with documented methamphetamine use to determine whether this patient group presents new dilemmas to the burn surgeon. A 2-year retrospective study of 30 patients (15 methamphetamine users, 15 controls) revealed that the methamphetamine burn patient requires two to three times the standard Parkland formula resuscitation. In this study, methamphetamine burns larger than 40% TBSA had a 100% mortality.
早期积极的液体复苏显著降低了与大面积烧伤所致容量丢失相关的发病率和死亡率。尽管大多数患者使用帕克兰公式进行复苏效果良好，但我们注意到，涉及甲基苯丙胺实验室爆炸的患者在休克复苏时的液体需求量增加。由于主要使用者是二三十岁的年轻健康个体，我们此前并未预料到该患者群体在烧伤休克复苏方面会失败。我们回顾了有甲基苯丙胺使用记录的烧伤患者的治疗经验，以确定该患者群体是否给烧伤外科医生带来了新的难题。一项对30例患者（15例甲基苯丙胺使用者，15例对照）的为期2年的回顾性研究显示，甲基苯丙胺烧伤患者所需的复苏液体量是标准帕克兰公式的两到三倍。在这项研究中，烧伤面积大于40%体表面积的甲基苯丙胺烧伤患者死亡率为100%。
