Stevens Jan V, Prieto Nina S, Ridelman Elika, Klein Justin D, Shanti Christina M
Department of Surgery, Division of Pediatric Surgery, Wayne State University/Children's Hospital of Michigan, 3901 Beaubien Blvd. #2129, Detroit, MI 48201, USA.
Department of Surgery, Division of Pediatric Surgery, Wayne State University/Children's Hospital of Michigan, 3901 Beaubien Blvd. #2215, Detroit, MI 48201, USA.
Burns. 2023 Feb;49(1):120-128. doi: 10.1016/j.burns.2022.03.007. Epub 2022 Mar 19.
Treatment for pediatric burns includes fluid resuscitation with formulas estimating fluid requirements based on weight and/or body surface area (BSA) with percent total body surface area burn (%TBSA burn). This study evaluates the risk of complications using weight-based resuscitation in children following burn injuries and compares fluid estimates with those that incorporate BSA. A retrospective review was conducted on 110 children admitted to an ABA-verified urban pediatric burn center over 12 years. Patients had ≥ 15% TBSA burn and were resuscitated with the weight-based Parkland formula. BSA-based Galveston and BSA-incorporated Cincinnati formula predictions were calculated. Complications were collected throughout hospital stay. Patients were classified into weight groups based on percentile. This study included 11 underweight, 60 normal weight, 18 overweight, and 21 obese children. Total fluid administered was higher as percentile increased; however, overweight children received more fluid than the obese (p = 0.023). The Galveston formula underpredicted fluid given over the first 24 h post-injury (p = 0.042); the Parkland and Cincinnati formula predictions did not significantly differ from fluids given. Further research is needed to determine the value of weight-based vs BSA-based or incorporated formulas in reducing risk of complications.
小儿烧伤的治疗包括根据体重和/或体表面积（BSA）以及烧伤占总体表面积的百分比（%TBSA烧伤）来估算液体需求量，并用公式进行液体复苏。本研究评估了烧伤儿童采用基于体重的复苏方法出现并发症的风险，并将液体估算值与纳入体表面积的估算值进行比较。对一家经美国烧伤协会认证的城市小儿烧伤中心12年间收治的110名儿童进行了回顾性研究。患者烧伤面积≥15%TBSA，并采用基于体重的帕克兰公式进行复苏。计算了基于体表面积的加尔维斯顿公式和纳入体表面积的辛辛那提公式的预测值。在整个住院期间收集并发症情况。根据百分位数将患者分为不同体重组。本研究纳入了11名体重过轻、60名正常体重、18名超重和21名肥胖儿童。随着百分位数增加，总补液量增多；然而，超重儿童比肥胖儿童接受的补液更多（p = 0.023）。加尔维斯顿公式对伤后最初24小时的补液量预测不足（p = 0.042）；帕克兰公式和辛辛那提公式的预测值与实际补液量无显著差异。需要进一步研究以确定基于体重的公式与基于体表面积或纳入体表面积的公式在降低并发症风险方面的价值。
