Safety of resuscitation with Ringer's acetate solution in severe burn (VolTRAB)--an observational trial

2.50
Hdl Handle:
http://hdl.handle.net/11287/593778
Title:
Safety of resuscitation with Ringer's acetate solution in severe burn (VolTRAB)--an observational trial
Authors:
Gille, J.; Klezcewski, B.; Malcharek, M.; Raff, T.; Mogk, M.; Sablotzki, A.; Taha, Hischam
Abstract:
BACKGROUND: A variety of crystalloids are available during fluid resuscitation of the severely burnt patient. There is a paucity of literature evidence on the comparative influence of these with regard to clinical outcomes. Significant differences in crystalloids may be clinically relevant given the large volumes employed during shock resuscitation. METHODS: The study compared two groups of severely burnt patients (TBSA 20-70%). Prospectively 40 consecutive patients treated with Ringer's acetate (RA group) against a retrospective control group of 40 patients treated with Ringer's lactate (RL group). Outcome parameters analysed included Sequential Organ Failure Assessment (SOFA)-scores at Days 3 and 7 after injury, mortality at 28 and 60 days, electrolyte and renal function, infection rates, cumulative volume administration and duration of ventilator support. RESULTS: Groups RA and RL were comparable w.r.t. age, total body surface area burn size and ABSI. SOFA-scores on Day 1 of admission also showed no significant difference but were significantly lower in RA group between the 3rd and 6th day. By Day 7 these differences could be attributed as a group effect (P=0.019). In particular low cardiovascular organ function scores contributed to this. Total crystalloid use within the first 28 days were equal in both but differed within the RA group having lower observed volumes of colloid and incidence of blood transfusion. Furthermore group RA had distinctly higher levels of platelets throughout treatment. Elevated lactate levels were noted in RL group during the initial three days. Survival rates at 28 days and 60 days showed no significant difference. CONCLUSION: Ringer's acetate solution is a suitable medium for the initial fluid management of the acutely burnt patient. In comparison to Ringer's lactate solution the study revealed lower SOFA-scores for Ringer's acetate solution (ClinicalTrials.gov number, NCT00609700).
Citation:
Burns. 2014 Aug;40(5):871-80.
Publisher:
Elsevier
Journal:
Burns : journal of the International Society for Burn Injuries
Issue Date:
1-Aug-2014
URI:
http://hdl.handle.net/11287/593778
DOI:
10.1016/j.burns.2013.11.021
PubMed ID:
24342121
Additional Links:
http://linkinghub.elsevier.com/retrieve/pii/S0305-4179(13)00397-5
Type:
Journal Article; Comparative Study; Observational Study
Language:
eng
ISSN:
1879-1409
Appears in Collections:
Plastic & Reconstructive Surgery; 2014 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorGille, J.en
dc.contributor.authorKlezcewski, B.en
dc.contributor.authorMalcharek, M.en
dc.contributor.authorRaff, T.en
dc.contributor.authorMogk, M.en
dc.contributor.authorSablotzki, A.en
dc.contributor.authorTaha, Hischamen
dc.date.accessioned2016-01-19T12:34:49Zen
dc.date.available2016-01-19T12:34:49Zen
dc.date.issued2014-08-01en
dc.identifier.citationBurns. 2014 Aug;40(5):871-80.en
dc.identifier.issn1879-1409en
dc.identifier.pmid24342121en
dc.identifier.doi10.1016/j.burns.2013.11.021en
dc.identifier.urihttp://hdl.handle.net/11287/593778en
dc.description.abstractBACKGROUND: A variety of crystalloids are available during fluid resuscitation of the severely burnt patient. There is a paucity of literature evidence on the comparative influence of these with regard to clinical outcomes. Significant differences in crystalloids may be clinically relevant given the large volumes employed during shock resuscitation. METHODS: The study compared two groups of severely burnt patients (TBSA 20-70%). Prospectively 40 consecutive patients treated with Ringer's acetate (RA group) against a retrospective control group of 40 patients treated with Ringer's lactate (RL group). Outcome parameters analysed included Sequential Organ Failure Assessment (SOFA)-scores at Days 3 and 7 after injury, mortality at 28 and 60 days, electrolyte and renal function, infection rates, cumulative volume administration and duration of ventilator support. RESULTS: Groups RA and RL were comparable w.r.t. age, total body surface area burn size and ABSI. SOFA-scores on Day 1 of admission also showed no significant difference but were significantly lower in RA group between the 3rd and 6th day. By Day 7 these differences could be attributed as a group effect (P=0.019). In particular low cardiovascular organ function scores contributed to this. Total crystalloid use within the first 28 days were equal in both but differed within the RA group having lower observed volumes of colloid and incidence of blood transfusion. Furthermore group RA had distinctly higher levels of platelets throughout treatment. Elevated lactate levels were noted in RL group during the initial three days. Survival rates at 28 days and 60 days showed no significant difference. CONCLUSION: Ringer's acetate solution is a suitable medium for the initial fluid management of the acutely burnt patient. In comparison to Ringer's lactate solution the study revealed lower SOFA-scores for Ringer's acetate solution (ClinicalTrials.gov number, NCT00609700).en
dc.language.isoengen
dc.publisherElsevieren
dc.relation.urlhttp://linkinghub.elsevier.com/retrieve/pii/S0305-4179(13)00397-5en
dc.titleSafety of resuscitation with Ringer's acetate solution in severe burn (VolTRAB)--an observational trialen
dc.typeJournal Articleen
dc.typeComparative Studyen
dc.typeObservational Studyen
dc.identifier.journalBurns : journal of the International Society for Burn Injuriesen

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