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Early Management of Burn Patients and Fluid Resuscitation

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Handbook of Burns Volume 1

Abstract

Appropriate early management of burns will lead to better outcomes. Of the “ABCs” of initial management of burns, this chapter covers “circulation” (“C”) and its complications. The pathophysiology of burn shock results from a massive capillary leak that involves alterations in the junctions between vascular endothelial cells. In addition, the glycocalyx that lines endothelial cells has been found to be a major regulator of capillary leak. The concepts of burn resuscitation are relatively straight forward—one must use a formula to estimate the starting rate and then all further adjustments are based on the patient’s physiologic response. In the past, crystalloids were the resuscitation fluids of choice, but that philosophy is changing to the increasing use of colloids. Studies suggest that colloids may reduce total fluid volumes and therefore reduce the complications of excessive fluid resuscitation. Finally, the management of resuscitation complications such as compartment syndrome is covered.

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Authors and Affiliations

  1. Shriners Hospitals for Children Northern California, Sacramento, CA, USA

    David G. Greenhalgh

  2. Burn Division, Firefighters Regional Burn Center at University of California, Davis, Sacramento, CA, USA

    David G. Greenhalgh

  3. Department of Surgery, University of California, Davis, Davis, CA, USA

    David G. Greenhalgh

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  1. David G. Greenhalgh
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Correspondence to David G. Greenhalgh .

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Editors and Affiliations

  1. Ross Tilley Burn Centre Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Marc G. Jeschke

  2. Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria

    Lars-Peter Kamolz

  3. Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

    Folke Sjöberg

  4. Department of Surgery, University of Texas Health Science Center, San Antonio, TX, USA

    Steven E. Wolf

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Greenhalgh, D.G. (2020). Early Management of Burn Patients and Fluid Resuscitation. In: Jeschke, M., Kamolz, LP., Sjöberg, F., Wolf, S. (eds) Handbook of Burns Volume 1. Springer, Cham. https://doi.org/10.1007/978-3-030-18940-2_15

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  • DOI: https://doi.org/10.1007/978-3-030-18940-2_15

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