213 Evaluation of Vasopressor Use During Acute Burn Fluid Resuscitation

Pape, K; Heard, Jason; Grieve, Brian; Galet, Colette; Wibbenmeyer, Lucy

doi:10.1093/jbcr/irz013.141

Cited by 1 publication

(6 citation statements)

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“…These results were in line with findings by Pape et al, who found that high Baux score and high %TBSA burnt were associated with vasopressor use. 21 In the latter study, vasopressors were used in 18% of the patients, and vasopressor use was associated with more frequent dialysis treatment and increased mortality. 21 Clinicians treating patients with major burns resuscitate with crystalloids to avoid hypovolemia and ensure tissue perfusion.…”

Section: Discussionmentioning

confidence: 94%

“…21 In the latter study, vasopressors were used in 18% of the patients, and vasopressor use was associated with more frequent dialysis treatment and increased mortality. 21 Clinicians treating patients with major burns resuscitate with crystalloids to avoid hypovolemia and ensure tissue perfusion. In patients who remain hypotensive despite adequate volume therapy, advanced hemodynamic monitoring may help to assess whether the patient has a hypovolaemic shock, or if there are elements of other types of shock such as cardiogenic and/or septic shock.…”

Section: Discussionmentioning

confidence: 94%

“…The study by Pape et al comprised 111 patients divided into patients receiving fluid and vasopressor (VP+) ( n = 20) versus only fluid (VP−) ( n = 91) 21 . Study results revealed that patients in the VP+ group were older, had a higher %TBSA burnt, higher fluid requirements in the first 24 h, and higher Baux scores compared to the VP− group.…”

Section: Resultsmentioning

confidence: 99%

“…After assessing 115 publications in full text, two retrospective cohort studies were included (PRISMA flowchart presented in Figure 1). 21,22 One of them was published as a conference abstract, the other as a full article. Among records not included, four were not available when sought from two separate medical libraries.…”

Section: Study Selectionmentioning

confidence: 99%

“…We extracted data from the two included studies by Pape et al and Adibfar et al 21,22 The main findings are presented in Table 2. In these studies, vasoactive and/or inotropic drugs were used in 18% and 31% of the patients, respectively.…”

Section: Data Extractionmentioning

confidence: 99%

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Vasoactive and/or inotropic drugs in initial resuscitation of burn injuries: A systematic review

Knappskog

Andersen

Guttormsen

et al. 2022

Acta Anaesthesiol Scand

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Background: According to current guidelines, initial burn resuscitation should be performed with fluids alone. The aims of the study were to review the frequency of use of vasoactive and/or inotropic drugs in initial burn resuscitation, and assess the benefits and harms of adding such drugs to fluids. Methods: A systematic literature search was conducted in PubMed, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, UpToDate, and SveMed+ through 3 December 2021. The search included studies on critically ill burn patients receiving vasoactive and/or inotropic drugs in addition to fluids within 48 h after burn injury.Results: The literature search identified 1058 unique publications that were screened for inclusion. After assessing 115 publications in full text, only two retrospective cohort studies were included. One study found that 16 out of 52 (31%) patients received vasopressor(s). Factors associated with vasopressor use were increasing age, burn depth, and % total body surface area (TBSA) burnt. Another study observed that 20 out of 111 (18%) patients received vasopressor(s). Vasopressor use was associated with increasing age, Baux score, and %TBSA burnt in addition to more frequent dialysis treatment and increased mortality. Study quality assessed by the Newcastle-Ottawa quality assessment scale was considered good in one study, but uncertain due to limited description of methods in the other. Conclusion:This systematic review revealed that there is a lack of evidence regarding the benefits and harms of using vasoactive and/or inotropic drugs in addition to fluids during early resuscitation of patients with major burns.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Data Extractionmentioning

confidence: 99%

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