Graves T A, Cioffi W G, McManus W F, Mason A D, Pruitt B A
U. S. Army Institute of Surgical Research, Fort Sam, Houston, Texas.
J Trauma. 1988 Dec;28(12):1656-9. doi: 10.1097/00005373-198812000-00007.
Age-related limitations of physiologic reserve in burned children make adequacy of intravenous fluid resuscitation critical. To quantify fluid requirements, the medical records of all children admitted to the Army Institute of Surgical Research from 1980 to 1986 whose weight was 25 kilograms or less and burn size was 25% or greater were reviewed to quantify fluid requirements. Forty-three children ranging in age from 1.5-108 months (means 26 +/- 22 m), with 25-89% total body surface burned (TBSB) (means 41.7% +/- 14.6%), met inclusion criteria. The average total volume of fluid received during the first 24 hours was 6.3 +/- 2.2 cc/kg/% TBSB. The net volume of resuscitation fluid, total volume less the calculated maintenance fluid requirements, was 3.91 +/- 2.2 cc/kg/% TBSB. Univariate analysis and linear regression of independent variables including age, weight, per cent full thickness, and inhalation injury revealed each had no significant influence on the volume of resuscitation. We recommend supplying maintenance volume and initiating burn resuscitation at 3 cc/kg/% TBSB.
烧伤儿童生理储备的年龄相关限制使得静脉液体复苏的充分性至关重要。为了量化液体需求量，回顾了1980年至1986年入住陆军外科研究所且体重25千克及以下、烧伤面积25%及以上的所有儿童的病历，以量化液体需求量。43名年龄在1.5至108个月（平均26±22个月）、全身烧伤面积（TBSB）为25%至89%（平均41.7%±14.6%）的儿童符合纳入标准。头24小时内接受的液体平均总量为6.3±2.2毫升/千克/%TBSB。复苏液体的净量，即总量减去计算出的维持液体需求量，为3.91±2.2毫升/千克/%TBSB。对包括年龄、体重、全层烧伤百分比和吸入性损伤在内的自变量进行单因素分析和线性回归发现，每个因素对复苏量均无显著影响。我们建议提供维持量，并以3毫升/千克/%TBSB开始烧伤复苏。
