Journal
CRITICAL CARE CLINICS
Volume 32, Issue 4, Pages 599-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.ccc.2016.06.008
Keywords
Fluid resuscitation; Burns; Decision making-Computer-Assisted; Decision support systems; Clinical
Categories
Funding
- Combat Casualty Care Research Program of the US Army Medical Research and Materiel Command, Fort Detrick, MD
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Fluid resuscitation of burn patients is commonly initiated using modified Brooke or Parkland formula. The fluid infusion rate is titrated up or down hourly to maintain adequate urine output and other endpoints. Over-resuscitation leads to morbid complications. Adherence to paper-based protocols, flow sheets, and clinical practice guidelines is associated with decreased fluid resuscitation volumes and complications. Computerized tools assist providers. Although completely autonomous closed-loop control of resuscitation has been demonstrated in animal models of burn shock, the major advantages of open-loop and decision-support systems are identifying trends, enhancing situational awareness, and encouraging burn team communication.
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