Tridente Ascanio, Lloyd Joanne, Saggers Pete, Lee Nicole, Sloan Brendan, Puxty Kathryn, Shokrollahi Kayvan, Dempsey Nina C
Intensive Care Unit, Whiston Hospital, Mersey & West Lancashire NHS Trust, Prescot L35 5DR, UK.
St. Andrew's Burns Centre, Broomfield Hospital, Chelmsford CM1 7ET, UK.
Eur Burn J. 2025 Jul 9;6(3):40. doi: 10.3390/ebj6030040.
Fluid management is a critical component in the treatment of patients suffering with major burns. Clinicians must carefully balance judicious resuscitation with the risks of over- or under-resuscitation. We aimed to identify factors associated with survival in burns patients and determine the importance of resuscitation practices. Patients requiring admission to Burns Services in the United Kingdom between 1 April 2022 and 31 March 2023 were included in the National Burns Audit project on fluid resuscitation practices, to evaluate factors associated with survival and Critical Care Length of Stay (CCLoS). A total of 198 patients were included in the analyses, with median age of 51 years (interquartile range, (IQR) 35-62 years), median Total Burn Surface Area (TBSA%) of 27.5% (IQR 20-40%), and median Baux score 82.5 (IQR 66-105). The following were found to be significant for survival: younger age, smaller TBSA%, lower Baux score and independence from renal replacement therapy. Neither the mechanism of burns nor the fluid resuscitation volumes appeared to influence survival. Although interventions such as tracheostomy or the number of surgical procedures did not appear to affect survival, fluid replacement of more than 6 mL/kg/%TBSA independently predicted longer CCLoS. Volume of fluid resuscitation, within the limits examined in this cohort, did not impact likelihood of survival.
液体管理是重度烧伤患者治疗中的关键组成部分。临床医生必须在合理复苏与复苏过度或不足的风险之间仔细权衡。我们旨在确定与烧伤患者生存相关的因素，并确定复苏措施的重要性。2022年4月1日至2023年3月31日期间需要入住英国烧伤科的患者被纳入了关于液体复苏实践的全国烧伤审计项目，以评估与生存及重症监护住院时间（CCLoS）相关的因素。共有198名患者纳入分析，中位年龄51岁（四分位间距，（IQR）35 - 62岁），中位烧伤总面积（TBSA%）为27.5%（IQR 20 - 40%），中位博克斯评分82.5（IQR 66 - 105）。发现以下因素对生存具有显著意义：年龄较小、TBSA%较小、博克斯评分较低以及无需肾脏替代治疗。烧伤机制和液体复苏量似乎均不影响生存。尽管气管切开术或手术操作次数等干预措施似乎不影响生存，但超过6 mL/kg/%TBSA的液体补充独立预测CCLoS更长。在本队列所研究的范围内，液体复苏量不影响生存可能性。
