Cappuyns Laura, Tridente Ascanio, Stubbington Yvonne, Dempsey-Hibbert Nina Claire, Shokrollahi Kayvan
Whiston Hospital, Prescot, Merseyside, UK.
Centre for Bioscience, Manchester Metropolitan University, Manchester, UK.
J Burn Care Res. 2023 Jan 5;44(1):81-86. doi: 10.1093/jbcr/irac106.
Ringer's lactate has been the most widely used fluid for burn resuscitation for decades. Plasmalyte® (PL), a newer balanced crystalloid, is gaining popularity for use in the critically ill, including patients with burns. This popularity is partly due to the fact that PL theoretically offers a favorable metabolic profile, but may also be attributed to its relatively lower cost. Patients who are critically ill with large burns receive enormous volumes of fluids, especially during the resuscitation period. The choice of balanced crystalloid solution used is likely to have an impact on the metabolic status of patients and their overall outcomes. The choice of fluid for burn resuscitation has been one of the most researched topics in burn care and various types of fluids have been superseded based on research findings. This narrative review examines the evidence guiding fluid management in burns and explores the data supporting the use of balanced crystalloid solutions, in particular PL for burn resuscitation. Our literature search revealed only one study that focused on a direct comparison between PL and standard Ringer's Lactate for burn resuscitation. Based on the limited literature on the use of PL in burns, it is difficult to draw meaningful conclusions. Further research, into the suitability of PL for use in burns, is needed before formulary changes are instituted widely.
几十年来，乳酸林格氏液一直是烧伤复苏中使用最广泛的液体。Plasmalyte®（PL）是一种新型平衡晶体液，在包括烧伤患者在内的重症患者中越来越受欢迎。这种受欢迎程度部分是因为PL理论上具有良好的代谢特性，但也可能归因于其相对较低的成本。患有大面积烧伤的重症患者需要大量补液，尤其是在复苏阶段。所使用的平衡晶体液的选择可能会对患者的代谢状态及其总体预后产生影响。烧伤复苏液体的选择一直是烧伤护理中研究最多的课题之一，基于研究结果，各种类型的液体已被取代。这篇叙述性综述审视了指导烧伤液体管理的证据，并探讨了支持使用平衡晶体液的数据，特别是用于烧伤复苏的PL。我们的文献检索仅发现一项聚焦于PL与标准乳酸林格氏液用于烧伤复苏直接比较的研究。基于关于PL用于烧伤的有限文献，很难得出有意义的结论。在广泛进行处方变更之前，需要进一步研究PL用于烧伤的适用性。
