99 Retrospective Review of Pediatric Fluid Resuscitation at a Large Burn Center

Abstract Introduction Foundational approaches to burn fluid resuscitation were largely developed with the adult patient in mind. Experience has shown, however, that physiologic nuances between adults and children necessitate an adjusted approach for pediatric patients. As practice advanced account these differences, our center sought evaluate efficacy of population. The purpose this study was examine including trends complications, establish a baseline future quality improvement initiatives. Methods This retrospective review patients <14 years age treated 2017 2021. Descriptive statistics calculated. Results Over five-year period, 42 admitted total body surface area (TBSA) >20%, which 23 met inclusion/exclusion criteria. Average admission weight 31.8 kg average TBSA 39%. Contributing mechanisms injury flame (61%), scald (35%) chemical (4%). Concomitant inhalation diagnosed 17% hourly volume 6.9 mL/kg/TBSA mean duration 25.7 hours. Total administered throughout exceeded recommendations per Parkland formula 83% sample. Continuous albumin 74% initiated on at 10 hours post-injury. Boluses lactated ringer’s 30% 9% patients, respectively. Urine output averaged 60 mL/hr low optimal urine 15.9mL/hr high 25.5 mL/hr. Adverse events occurring during included temperature < 36◦C (35%), vasopressor administration (9%), intra-abdominal pressure >12 (13%) and/or >19 peripheral vascular pulses +1 (61%). Prophylactic escharotomy performed 35%. Of note, none compartment syndrome nor abdominal required laparotomy. One (4%) acute respiratory distress syndrome. renal replacement therapy (CRRT) not utilized any or post-resuscitation, compared 34% resuscitated same center. No expired initial 48 post-burn. overall survival rate population 91.3%, 87% discharged direct home. Conclusions Resuscitation volumes large have historically accepted rates resuscitation. Despite divergence from traditional practice, associated complications remain low, outcomes been favorable. Applicability Research Practice Further research is needed benchmarks