Compensation of fluids in patients with burns: Following a formula or individualized approach to patients?

Abstract

A burn injury is defined as damage to the skin and subcutaneous tissues caused by heat, electricity, or chemicals. Burns can be classified according to the mechanism and time of occurrence and according to the severity of the injury. The severity of the burn is most often determined about the depth and percentage of the affected surface, taking into account some specificities of the patients (age, presence of comorbidities) and the burns themselves (inhalation, circumferential, burns caused by electricity). Fluid resuscitation is the most important measure of the initial (but, and later) treatment of burn disease, which is carried out to prevent hypovolemia and the occurrence of burn shock. Inadequate or delayed fluid resuscitation leads to multisystemic organ dysfunction. On the other hand, excessive fluid replacement leads to the formation of edema and other complications, such as compartment syndromes, which also increase morbidity and mortality. Crystalloid solutions are the core of burn resuscitation, and the biggest dilemma is whether, when, and how many colloids should be included in therapy.