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非洲大陆的烧伤复苏。

Burn resuscitation on the African continent.

作者信息

Rode H, Rogers A D, Cox S G, Allorto N L, Stefani F, Bosco A, Greenhalgh D G

机构信息

Emeritus Professor of Paediatric Surgery, Division of Paediatric Surgery, Red Cross War Memorial Children's Hospitals and the University of Cape Town, Cape Town, South Africa.

Registrar, Division of Plastic, Reconstructive and Maxillofacial Surgery, Groote Schuur and Red Cross War Memorial Children's Hospitals and the University of Cape Town, Cape Town, South Africa.

出版信息

Burns. 2014 Nov;40(7):1283-91. doi: 10.1016/j.burns.2014.01.004. Epub 2014 Feb 19.

Abstract

A survey of members of the International Society of Burn Injuries (ISBI) and the American Burn Association (ABA) indicated that although there was difference in burn resuscitation protocols, they all fulfilled their functions. This study presents the findings of the same survey replicated in Africa, the only continent not included in the original survey. One hundred and eight responses were received. The mean annual number of admissions per unit was ninety-eight. Fluid resuscitation was usually initiated with total body surface area burns of either more than ten or more than fifteen percent. Twenty-six respondents made use of enteral resuscitation. The preferred resuscitation formula was the Parkland formula, and Ringer's Lactate was the favoured intravenous fluid. Despite satisfaction with the formula, many respondents believed that patients received volumes that differed from that predicted. Urine output was the principle guide to adequate resuscitation, with only twenty-one using the evolving clinical picture and thirty using invasive monitoring methods. Only fifty-one respondents replied to the question relating to the method of adjusting resuscitation. While colloids are not available in many parts of the African continent on account of cost, one might infer than African burn surgeons make better use of enteral resuscitation.

摘要

一项针对国际烧伤学会(ISBI)和美国烧伤协会(ABA)成员的调查表明,尽管烧伤复苏方案存在差异,但它们都能发挥各自的作用。本研究展示了在非洲重复进行的同一调查的结果,非洲是唯一未被纳入原始调查的大陆。共收到108份回复。各单位每年的平均入院人数为98人。通常在烧伤总面积超过10%或超过15%时开始进行液体复苏。26名受访者采用肠内复苏。首选的复苏公式是帕克兰公式,乳酸林格氏液是最常用的静脉输液。尽管对该公式感到满意,但许多受访者认为患者实际接受的液体量与预测值不同。尿量是判断复苏是否充分的主要指标,只有21人根据不断变化的临床情况进行判断,30人使用有创监测方法。只有51名受访者回答了与调整复苏方法相关的问题。由于成本原因,非洲大陆许多地区无法获得胶体液,由此可以推断,非洲烧伤外科医生更善于运用肠内复苏。

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