State Key Laboratory of Trauma, Burn and Combined Injury; Institute of Burn Research, Southwest Hospital, The Army Military Medical University (Third Military Medical University), Chongqing, China.
J Burn Care Res. 2021 Sep 30;42(5):962-967. doi: 10.1093/jbcr/irab013.
The Third Military Medical University (TMMU) formula is widely used in fluid resuscitation in China. However, the actual volume needs usually exceed the prediction provided by the TMMU formula in major burn patients with a high proportion of full-thickness burn wounds. This retrospective study included 149 adult major burn patients (≥40% TBSA) who were admitted to the Burn Department, Southwest Hospital from 2014 to 2020 and received appropriate fluid resuscitation by the TMMU protocol. The actual volume infused in the first 48 hours postburn was compared to the estimation by the TMMU formula. A new fluid volume prediction formula was developed by multivariate linear regression analysis. The mean fluid requirements were 2.35 ml/kg/% TBSA and 1.75 ml/kg/% TBSA in the first and second 24 hours postburn, respectively. The TMMU formula underestimated the fluid requirement, and its prediction accuracy was 54.1% and 25.8% for the first and second 24 hours, respectively. The proportion of full-thickness burn wound was found to be associated with the fluid requirements postburn. A revised multifactorial formula consisting of the burn index, body weight, and inhalation injury was developed. Using the revised formula, the prediction reliability of resuscitation fluid volume improved to 65.3% and 61.1% in the first and second 24 hours, respectively. The TMMU formula showed low accuracy in predicting fluid requirements among major burn patients. A revised formula based on burn index was developed to provide better guidance for initiative fluid resuscitation for major burns by the TMMU protocol.
第三军医大学（TMMU）公式在中国广泛应用于液体复苏。然而，在大面积烧伤患者（全层烧伤比例高）中，实际需要的液体量通常超过 TMMU 公式提供的预测值。本回顾性研究纳入了 2014 年至 2020 年期间在西南医院烧伤科收治的 149 例成人大面积烧伤患者（≥40% TBSA），这些患者根据 TMMU 方案接受了适当的液体复苏。比较了烧伤后 48 小时内输注的实际液体量与 TMMU 公式的估计值。通过多元线性回归分析，建立了新的液体量预测公式。烧伤后前 24 小时和后 24 小时的平均液体需求量分别为 2.35 ml/kg/%TBSA 和 1.75 ml/kg/%TBSA。TMMU 公式低估了液体需求，其在前 24 小时和后 24 小时的预测准确性分别为 54.1%和 25.8%。全层烧伤比例与烧伤后液体需求有关。建立了一个由烧伤指数、体重和吸入性损伤组成的修订多因素公式。使用修订后的公式，复苏液体量的预测可靠性在前 24 小时和后 24 小时分别提高到 65.3%和 61.1%。TMMU 公式在预测大面积烧伤患者液体需求方面准确性较低。根据烧伤指数建立了一个修订后的公式，为 TMMU 方案指导大面积烧伤的主动液体复苏提供了更好的指导。
Zhonghua Shao Shang Za Zhi. 2008-8
Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2022-3-20
Evid Based Complement Alternat Med. 2022-6-20
Front Med (Lausanne). 2025-3-4
Evid Based Complement Alternat Med. 2022-6-20
Zotero 插件