Treatment of patients with severe burn injuries is complex, relying on attentive fluid resuscitation, successful management concomitant injuries, prompt wound assessment and closure, early rehabilitation, compassionate psychosocial care. The goal resuscitation to maintain organ perfusion at the lowest possible physiologic cost. This requires careful, hourly titration infusion rate meet individu...

Guidelines • Adults and children with burns greater than 20% TBSA should undergo formal fluid resuscitation using estimates based on body size and surface area burned. • Common formulas used to initiate of resuscitation estimate a crystalloid need for 2 to 4 ml/kg body weight/%TBSA during the first 24 hours. • Fluid resuscitation, regardless of solution type or estimated need, should be titrate...

Fluid therapy is an important component of resuscitation and treatment of critically ill equine patients. However, the decision of which fluid type to use in certain critical situations is somewhat controversial. This article focuses on the potential benefits of performing small-volume resuscitation in critically ill horses by combining hypertonic saline with a colloid (e.g., hetastarch).

This brief update reviews the recent literature available on fluid resuscitation from hemorrhagic shock and considers the applicability of this evidence for use in resuscitation of combat casualties in the combat casualty care (CCC) environment. A number of changes need to be incorporated in the CCC guidelines: (1) dried plasma (DP) is added as an option when other blood components or whole blo...

The effects of resuscitation fluids on the brain have been investigated in previous studies by global measurements of cerebral blood flow and metabolism. In this study we have examined the effects of a novel haemoglobin-based oxygen carrier on local cerebral blood flow (LCBF) and local cerebral glucose utilization (LCGU) after resuscitation from a volume-controlled haemorrhage of 30 min (3.0 ml...

Key Take-Away Early and rapid fluid resuscitation has been shown to significantly impact health and economic metrics in pediatric septic shock; however, using current techniques providers are rarely able to achieve published fluid delivery guidelines. In this model of fluid resuscitation in pediatric septic shock, use of the LifeFlow Rapid Infuser resulted in lower expected mortality compared t...

Policies of fluid administration/restriction in critically ill patients have evolved over recent years. Abundant fluid resuscitation is encouraged during the early stage of severe sepsis. But a conservative fluid strategy is recommended in later stages, in particular when lungs are injured. Both strategies are risky if uncontrolled. Tests detecting volume unresponsiveness at any moment of fluid...

Controversy has continued regarding the practicality and accuracy of the Parkland burn formula since its introduction over 35 years ago. The best guide for adequacy of resuscitation is urine output (UOP) per hour. A retrospective study of patients resuscitated with the Parkland formula was conducted to determine the accuracy (calculated vs. actual volume) based on UOP. A review of burn resuscit...

An Italian survey on the treatment of acute pancreatitis published in 2007 [1] assessed the compliance of 56 medical and surgical centers equally distributed throughout Italy to the Italian guidelines on acute pancreatitis [2]. The severity of the disease was clinically assessed according to the Atlanta criteria [3] and the majority of patients were observed and treated early after the onset of...

The central venous pressure (CVP) is the most frequently used variable to guide fluid resuscitation in critically ill patients, although its use has been challenged. In this viewpoint, we use a question and answer format to highlight the potential advantages and limitations of using CVP measurements to guide fluid resuscitation.