Rousseau Anne-Françoise, Massion Paul B, Laungani Alexis, Nizet Jean-Luc, Damas Pierre, Ledoux Didier
From the *Intensive Care Department and Burn Centre and †Plastic Surgery Department and Burn Centre, University Hospital, Liège, Belgium.
J Burn Care Res. 2014 Jul-Aug;35(4):e234-9. doi: 10.1097/BCR.0000000000000027.
During the year 2011, a survey was performed to describe current practices throughout Europe regarding three critical issues of acute burn care, namely fluid resuscitation, nutrition, and burn wound excision strategy. Thirty-eight questionnaires returned by burn centres from 17 different European countries were analyzed. The survey shows that Parkland remains the most commonly used formula to determine fluid needs in adults. All respondent centers use urine output to guide fluid resuscitation. While early excision of deep burns is the rule among centers, burn depth assessment by laser Doppler imaging is used in only a few centers. Indirect calorimetry and Toronto formula to estimate energy requirements do not have unanimous backing from respondents. Current literature encourages clinicians to move forward targeted and individualized therapies using a bundle of basic and advanced hemodynamic parameters, indirect calorimetry, and laser Doppler imaging. The results of this study suggest that such an approach is not common yet, and reinforce the subsequent need for large clinical trials that would evaluate the impact of such guided therapies to provide recommendations with a significant level of evidence.
2011年，开展了一项调查，以描述欧洲各地目前在急性烧伤护理的三个关键问题上的做法，即液体复苏、营养和烧伤创面切除策略。对来自17个不同欧洲国家的烧伤中心返回的38份问卷进行了分析。调查显示，帕克兰公式仍然是确定成人液体需求量最常用的公式。所有应答中心都使用尿量来指导液体复苏。虽然早期切除深度烧伤是各中心的常规做法，但只有少数中心使用激光多普勒成像进行烧伤深度评估。间接测热法和多伦多公式来估计能量需求并未得到应答者的一致支持。当前文献鼓励临床医生使用一系列基本和高级血流动力学参数、间接测热法和激光多普勒成像推进有针对性的个体化治疗。这项研究的结果表明，这种方法目前还不常见，并强化了随后进行大型临床试验的必要性，这些试验将评估这种指导性治疗的影响，以提供具有显著证据水平的建议。
