Linked Life Data

20061837

Source:http://linkedlifedata.com/resource/pubmed/id/20061837

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2010-1-11
pubmed:abstractText
Administration of resuscitation volumes far beyond the estimates established by burn-body weight resuscitation formulas has been well documented. The reasons behind this increase are not clear. We sought to determine if our resuscitation volumes had increased and, if so, what factors were related to their increase. A retrospective chart review identified 154 patients admitted with burns greater than 20% of their BSA during the years of 1975-1976 (period 1), 1990-1991 (period 2), and 2006-2007 (period 3). Charts were reviewed for total fluids (crystalloid, colloid, and blood products) and opioids given before admission, during the first 8 hours of treatment, the next 16 hours of treatment, and the following 24 hours of treatment. Opioids were converted to opioid equivalents (OE). Multiple regression analysis was performed to determine the effects of variables of interest and control for confounders. Significance was assumed at the P < .05 level. Resuscitation fluid volumes increased significantly among adults from 3.97 ml/kg/%BSA during the first period to 6.40 ml/kg/%BSA during the third period (P < .01). The same trend in children <30 kg was not seen (P = .72). Fluid administered during the first 24 hours was significantly associated with age, BSA, intubation, latter two study periods, and opioid administration. Fluid administration was consistently associated with opioid administration at all measured time points. At 24 hours postburn, patients who received 2 to 4 OE/kg required an average of additional 3,650 +/- 1,704 ml of fluid, those receiving 4 to 6 OE/kg had required an average of 25,154 +/- 4,386 ml, and those who received >6 OE kg had required an average of 32,969 +/- 3,982 ml. In this single center retrospective study, we have shown a statistically significant increase in resuscitation fluids (from 1975 to 2007) and an association of resuscitation volumes with opioids. Opioids have been shown to increase resuscitation volumes in critically ill patients through both central and peripheral effects on the cardiovascular system. Because increased fluid resuscitation has been associated with adverse consequences in other studies, further research on alternative pain control strategies in thermally injured patients is warranted.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
1559-0488
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
31
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
48-56
pubmed:meshHeading
pubmed-meshheading:20061837-Adolescent, pubmed-meshheading:20061837-Adult, pubmed-meshheading:20061837-Analgesics, Opioid, pubmed-meshheading:20061837-Burns, pubmed-meshheading:20061837-Child, pubmed-meshheading:20061837-Cohort Studies, pubmed-meshheading:20061837-Colloids, pubmed-meshheading:20061837-Dose-Response Relationship, Drug, pubmed-meshheading:20061837-Female, pubmed-meshheading:20061837-Fluid Therapy, pubmed-meshheading:20061837-Humans, pubmed-meshheading:20061837-Isotonic Solutions, pubmed-meshheading:20061837-Male, pubmed-meshheading:20061837-Middle Aged, pubmed-meshheading:20061837-Pain, pubmed-meshheading:20061837-Plasma Substitutes, pubmed-meshheading:20061837-Retrospective Studies, pubmed-meshheading:20061837-Risk Factors, pubmed-meshheading:20061837-Severity of Illness Index, pubmed-meshheading:20061837-Young Adult
pubmed:articleTitle
The impact of opioid administration on resuscitation volumes in thermally injured patients.
pubmed:affiliation
Department of Surgery, The University of Iowa Carver College of Medicine, Iowa City, UT 52246, USA.
pubmed:publicationType
Journal Article