Establishment and application of the tenfold rehydration formula for emergency resuscitation of adult patients after extensive burns

Shen Chuan'an; Liu Xinzhu; Li Dawei; Liu Zhaoxing; Zhang Bohan

doi:10.3760/cma.j.cn501120-20211109-00383

Volume 38 Issue 3

Mar. 2022

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2022 > 38(3): 236-241

Wang H,Zhao P,Sun D,et al.Epidemiological characteristics and the establishment and evaluation of a risk prediction model for nosocomial infection in burn patients[J].Chin J Burns Wounds,2022,38(12):1170-1178.DOI: 10.3760/cma.j.cn501225-20220214-00025.

Citation:

Shen CA,Liu XZ,Li DW,et al.Establishment and application of the tenfold rehydration formula for emergency resusof adult patients after extensive burns[J].Chin J Burns Wounds,2022,38(3):236-241.DOI: 10.3760/cma.j.cn501120-20211109-00383.

Citation:

PDF( 1150 KB)

Establishment and application of the tenfold rehydration formula for emergency resuscitation of adult patients after extensive burns

doi: 10.3760/cma.j.cn501120-20211109-00383

Department of Burns and Plastic Surgery, the Fourth Medical Center of PLA General Hospital, Beijing 100048, China

Funds:

General Program of National Natural Science Foundation of China 82072169

Major Program of Military Logistics Research Plan ALB18J001

More Information

Corresponding author: Shen Chuan'an, Email: shenchuanan@126.com
Received Date: 2021-11-09

Abstract

Abstract

Objective To explore the scientificity and feasibility of the tenfold rehydration formula for emergency resuscitation of adult patients after extensive burns. Methods A retrospective observational study was conducted. The total burn area (30%-100% total body surface area (TBSA)) and body weight (45-135 kg) of 170 adult patients (135 males and 35 females, aged (42±14) years) with extensive burns admitted to the Fourth Medical Center of PLA General Hospital from December 2016 to December 2019 were collected. The 6 461 pairs of simulated data obtained after pairing each body weight in 45 to 135 kg (programmed in steps of 1 kg) with each area in 30% to 100% TBSA (programmed in steps of 1%TBSA) were plugged into four recognized rehydration formulas--Parkland's formula, Brooke's formula, the 304th PLA Hospital formula, and the Third Military Medical University formula and two emergency rehydration formulas--the simplified first aid resuscitation plan for extensive burn patients proposed by the World Health Organization's Technical Working Group on Burns (TWGB, hereinafter referred to as the TWGB formula) and the tenfold rehydration formula proposed by the author of this article to calculate the rehydration rate within 8 hours after injury (hereinafter referred to as the rehydration rate), with results being displayed by a programming step of 10%TBSA for the total burn area. Taking the calculation results of four recognized rehydration formulas as the reasonable rehydration rate, the accuracy of rehydration rates calculated by two emergency rehydration formulas were calculated and compared. The body weight of 45-135 kg was divided into three segments by the results of maximum body weight at a reasonable rehydration rate calculated by the tenfold rehydration formula when the total burn area was 30% and 100% TBSA, respectively. The accuracy of rehydration rate calculated by two emergency rehydration formulas in each body weight segment was compared. When the rehydration rates calculated by two emergency rehydration formulas were unreasonable, the differences in rehydration rates between the two were compared. Statistical distribution of the aforementioned three body weight segments in the aforementioned 170 patients was counted. Using the total burn area and body weight data of the aforementioned 170 patients, the accuracy of rehydration rate calculated by two emergency rehydration formulas was calculated and compared as before. Data were statistically analyzed with McNemar test. Results When the total burn area was 30%, 40%, 50%, 60%, 70%, 80%, 90%, and 100% TBSA, respectively, and the body weight was 45-135 kg, the rehydration rates calculated by two emergency rehydration formulas did not exceed the maximum of the calculated results of four recognized rehydration formulas; the rehydration rate calculated by the TWGB formula did not change accordingly with total burn area, while the rehydration rate calculated by the tenfold rehydration formula did not change accordingly with body weight. Substituting 6 461 pairs of simulated data showed that the accuracy of rehydration rate calculated by the tenfold rehydration formula was 43.09% (2 784/6 461), which was significantly higher than 2.07% (134/6 461) of the TWGB formula, χ²=2 404.80, P<0.01. When the body weights were 45-62 kg and 63-93 kg, the accuracy rates of rehydration rate calculated by the tenfold rehydration formula were 100% (1 278/1 278) and 68.42% (1 506/2 201), respectively, which were significantly higher than 0 (0/1 278) and 0.05% (1/2 201) of the TWGB formula, χ²=1 276.00, 1 501.01, P<0.01; when the body weight was 94-135 kg, the accuracy rate of rehydration rate calculated by the tenfold rehydration formula was 0 (0/2 982), which was significantly lower than 4.46% (133/2 982) of the TWGB formula, χ²=131.01, P<0.01. When the rehydration rates calculated by two emergency rehydration formulas were both unreasonable, the rehydration rate calculated by the tenfold rehydration formula was greater than that calculated by the TWGB formula in most cases, accounting for 79.3% (2 808/3 543). Among the 170 patients, the proportions of those weighing 45-62, 63-93, and 94-135 kg were 25.29% (43/170), 65.88% (112/170), and 8.82% (15/170), respectively. Among the 170 patients, the accuracy rate of rehydration rate calculated by the tenfold rehydration formula was 69.41% (118/170), which was significantly higher than 3.53% (6/170) of the TWGB formula, χ²=99.36, P<0.01. Conclusions Applying the tenfold rehydration formula to calculate the emergency rehydration rate in adults after extensive burns is simpler than four recognized rehydration formulas, and is superior to the TWGB formula. The tenfold rehydration formula is suitable for the front-line medical staffs that are not specialized in burns in pre-admission rescue of adult patients with extensive burns, which is worth popularizing.
- Burns,
- Shock,
- First aid,
- Tenfold rehydration formula,
- Resuscitation

FullText(HTML)

References(24)

References

[1]	JeschkeMG,van BaarME,ChoudhryMA,et al.Burn injury[J].Nat Rev Dis Primers,2020,6(1):11.DOI: 10.1038/s41572-020-0145-5.
[2]	CopeO,MooreFD.The redistribution of body water and the fluid therapy of the burned patient[J].Ann Surg,1947,126(6):1010-1045.DOI: 10.1097/00000658-194712000-00013.
[3]	PeckM,JengJ,MoghazyA.Burn resuscitation in the austere environment[J].Crit Care Clin,2016,32(4):561-565.DOI: 10.1016/j.ccc.2016.06.010.
[4]	ChungKK,WolfSE,CancioLC,et al.Resuscitation of severely burned military casualties: fluid begets more fluid[J].J Trauma,2009,67(2):231-237; discussion 237.DOI: 10.1097/TA.0b013e3181ac68cf.
[5]	KearnsRD,ConlonKM,MatherlyAF,et al.Guidelines for burn care under austere conditions: introduction to burn disaster, airway and ventilator management, and fluid resuscitation[J].J Burn Care Res,2016,37(5):e427-439.DOI: 10.1097/BCR.0000000000000304.
[6]	HughesA,AlmelandSK,LeclercT,et al.Recommendations for burns care in mass casualty incidents: WHO Emergency Medical Teams Technical Working Group on Burns (WHO TWGB) 2017-2020[J].Burns,2021,47(2):349-370.DOI: 10.1016/j.burns.2020.07.001.
[7]	申传安.危重烧伤救治新技术体系.北京:人民卫生出版社,2021:40.
[8]	杨宗城. 烧伤治疗学.北京:人民卫生出版社,2005:161,166.
[9]	GillenwaterJ,GarnerW.Acute fluid management of large burns: pathophysiology, monitoring, and resuscitation[J].Clin Plast Surg,2017,44(3):495-503.DOI: 10.1016/j.cps.2017.02.008.
[10]	KangD,YooKY.Fluid management in perioperative and critically ill patients[J].Acute Crit Care,2019,34(4):235-245.DOI: 10.4266/acc.2019.00717.
[11]	ClarkA,NeyraJA,MadniT,et al.Acute kidney injury after burn[J].Burns,2017,43(5):898-908.DOI: 10.1016/j.burns.2017.01.023.
[12]	SuK,XueFS,XueZJ,et al.Clinical characteristics and risk factors of early acute kidney injury in severely burned patients[J].Burns,2021,47(2):498-499.DOI: 10.1016/j.burns.2020.08.018.
[13]	郭振荣.烧伤休克期补液[J].中华烧伤杂志,2008,24(5):328-330.DOI: 10.3760/cma.j.issn.1009-2587.2008.05.004.
[14]	World Health OrganizationBurns20182018-03-062021-11-09https://www.who.int/en/news-room/fact-sheets/detail/burn World Health Organization.Burns[EB/OL].2018(2018-03-06)[2021-11-09].https://www.who.int/en/news-room/fact-sheets/detail/burn.
[15]	RaeL,FidlerP,GibranN.The physiologic basis of burn shock and the need for aggressive fluid resuscitation[J].Crit Care Clin,2016,32(4):491-505.DOI: 10.1016/j.ccc.2016.06.001.
[16]	LeclercT,PotokarT,HughesA,et al.A simplified fluid resuscitation formula for burns in mass casualty scenarios: analysis of the consensus recommendation from the WHO Emergency Medical Teams Technical Working Group on Burns[J].Burns,2021,47(8):1730-1738.DOI: 10.1016/j.burns.2021.02.022.
[17]	PeetersY,LebeerM,WiseR,et al.An overview on fluid resuscitation and resuscitation endpoints in burns: past, present and future. Part 2 - avoiding complications by using the right endpoints with a new personalized protocolized approach[J].Anaesthesiol Intensive Ther,2015,47 Spec No:s15-26.DOI: 10.5603/AIT.a2015.0064.
[18]	GuilabertP,UsúaG,MartínN,et al.Fluid resuscitation management in patients with burns: update[J].Br J Anaesth,2016,117(3):284-296.DOI: 10.1093/bja/aew266.
[19]	LeeKC,JooryK,MoiemenNS.History of burns: the past, present and the future[J/OL].Burns Trauma,2014,2(4):169-180[2021-11-09]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4978094/.DOI: 10.4103/2321-3868.143620.
[20]	AhujaRB,BhattacharyaS.An analysis of 11,196 burn admissions and evaluation of conservative management techniques[J].Burns,2002,28(6):555-561.DOI: 10.1016/s0305-4179(02)00069-4.
[21]	SoussiS,DépretF,BenyaminaM,et al.Early hemodynamic management of critically ill burn patients[J].Anesthesiology,2018,129(3):583-589.DOI: 10.1097/ALN.0000000000002314.
[22]	BaxterCR,ShiresT.Physiological response to crystalloid resuscitation of severe burns[J].Ann N Y Acad Sci,1968,150(3):874-894.DOI: 10.1111/j.1749-6632.1968.tb14738.x.
[23]	EvansEI,PurnellOJ,RobinettPW,et al.Fluid and electrolyte requirements in severe burns[J].Ann Surg,1952,135(6):804-817.DOI: 10.1097/00000658-195206000-00006.
[24]	PruittBAJr.Fluid and electrolyte replacement in the burned patient[J].Surg Clin North Am,1978,58(6):1291-1312.DOI: 10.1016/s0039-6109(16)41692-0.

Relative Articles

[1]	Zheng Xinxin, Kong Ling'ai, Lyu Rang, Xu Caijuan. Analysis of epidemiological characteristics and risk factors of catheter-associated urinary tract infections in patients with perineal and/or hip burns[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2024, 40(3): 289-295. doi: 10.3760/cma.j.cn501225-20231027-00138
[2]	Jiang Shengpan, Gao Xiaoqing, Luan Xiagang, Tan Yiqing. Establishment and validation of a risk prediction model for pulmonary embolism in severe burn patients[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2024, 40(12): 1114-1122. doi: 10.3760/cma.j.cn501225-20240122-00028
[3]	Ma Qimin, Tang Wenbin, Li Xiaojian, Chang Fei, Yin Xi, Chen Zhaohong, Wu Guohua, Xia Chengde, Li Xiaoliang, Wang Deyun, Chu Zhigang, Zhang Yi, Wang Lei, Wu Choulang, Tong Yalin, Cui Pei, Guo Guanghua, Zhu Zhihao, Huang Shengyu, Chang Liu, Liu Rui, Liu Yongji, Wang Yusong, Liu Xiaobin, Shen Tuo, Zhu Feng. Multicenter retrospect analysis of early clinical features and analysis of risk factors on prognosis of elderly patients with severe burns[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2024, 40(3): 249-257. doi: 10.3760/cma.j.cn501225-20230808-00042
[4]	Jiang Nanhong, Xie Weiguo, Wang Deyun, Chu Zhigang, Xi Maomao, Zhou Jinxiu, Li Feng. Analysis of risk factors for atrial fibrillation in adult patients with critically severe burns after the first surgery[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2024, 40(9): 857-865. doi: 10.3760/cma.j.cn501225-20240329-00111
[5]	Yang Sisi, Zhao Yuanyu, Luo Zhenjin, He Chong, Li Yunheng. Clinical characteristics and analysis of risk factors for heart injuries in 55 patients with lightning injury on plateau in Tibet Autonomous Region[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(10): 968-976. doi: 10.3760/cma.j.cn501225-20230413-00124
[6]	Pan Xuanliang, Zhu Zhikang, Shen Tao, Jin Fang, Wang Xingang, Yin Jun, Han Chunmao. Epidemiological characteristics and risk factors of sepsis development and death in patients with extremely severe burns[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(6): 558-564. doi: 10.3760/cma.j.cn501225-20220806-00336
[7]	Chen Nuo, Xi Maomao, Ruan Qiongfang, Chu Zhigang, Zhang Wei, Zhang Jinli, Xie Weiguo. Risk factors of early myocardial injury and the impact of early myocardial injury on prognosis of patients with extensive burns[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(5): 417-423. doi: 10.3760/cma.j.cn501225-20230308-00074
[8]	Tang Wenbin, Chen Bin, Ou Shali, Li Xinying, Xiao Kui, Wang Sisi, Li Xiaojian. Analysis of the risk factors of persistent inflammation-immunosuppression-catabolism syndrome in patients with extensive burns[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(4): 350-355. doi: 10.3760/cma.j.cn501225-20220214-00028
[9]	Li Yanguang, Chang Shuailei, Xie Jiangfan, Ye Xiangyang, Wang Lei, Li Yancang, Li Yun, Li Xiaoliang. Analysis of clinical characteristics and risk factors of death in critical burn patients complicated with invasive fungal infection[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(7): 618-624. doi: 10.3760/cma.j.cn501225-20230415-00127
[10]	Han Chao, Ji Peng, Shang Yage, Li Jin, Wang Kejia, Cao Tao, Hu Dahai, Tao Ke. Epidemiological characteristics of nosocomial infection in hospitalized children with burns and the establishment and verification of a risk prediction model[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2023, 39(11): 1006-1013. doi: 10.3760/cma.j.cn501225-20230812-00046
[11]	Chen Bin, Tang Wenbin, Li Xiaojian, Ou Shali, Li Xinying, Xiao Kui, Wang Sisi. Analysis of the clinical characteristics and risk factors of postoperative atrial fibrillation in patients with critical burns[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2022, 38(5): 408-414. doi: 10.3760/cma.j.cn501225-20220214-00026
[12]	Ren Haitao, Chen Huaqing, Han Chunmao. Establishment of a predictive model for acute respiratory distress syndrome and analysis of its predictive value in critical burn patients[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2021, 37(4): 333-339. doi: 10.3760/cma.j.cn501120-20200301-00109
[13]	Zhang Wei, Zhang Junfeng, Wang Mi, Xia Chengde, Wang Lijie, Liu Baohui, Di Haiping, Xue Jidong, Lou Jihe. Occurrence of deep venous thrombosis in adult burn patients and its risk factors[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2020, 36(1): 54-57. doi: 10.3760/cma.j.issn.1009-2587.2020.01.010
[14]	Ren Haitao, Han Chunmao, Zhang Jingjing, Hu Hang, Zhang Rong. Epidemiological investigation of burn patients with Klebsiella pneumoniae infection and the analysis of risk factors for sepsis in them[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2019, 35(6): 456-458. doi: 10.3760/cma.j.issn.1009-2587.2019.06.011
[15]	Liu Xiaolong, Su Fuzeng, Zha Tianjian, Liu Lihua, Wang Zhizhong, Nuerlan null. Analysis on the risk factors of diabetic foot ulcer in diabetic patients of Uyghur nationality and Han nationality in the Xinjiang Uygur Autonomous Region[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2017, 33(8): 486-490. doi: 10.3760/cma.j.issn.1009-2587.2017.08.006
[16]	Fang Li, Wang Fan, Sun Kedai, Zhou Tao, Gong Yali, Peng Yizhi. Analysis on the prevalence of central venous catheter-related infection in burn patients and its risk factors[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2016, 32(4): 243-248. doi: 10.3760/cma.j.issn.1009-2587.2016.04.013
[19]	SHI Miao-miao, ZHAO Dong-mei, WANG Qiang, CHENG Jun, MA Tai, XU Yuan-hong, XU Qing-lian, LI Jia-bin. Analysis of drug resistance and risk factors of Enterobacteriaceae in burn units[J]. CHINESE JOURNAL OF BURNS AND WOUNDS, 2010, 26(3): 199-201. doi: 10.3760/cma.j.issn.1009-2587.2010.03.009

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(2)

Get Citation

PDF

XML

Article Metrics

Article views (833) PDF downloads(122)

Establishment and application of the tenfold rehydration formula for emergency resuscitation of adult patients after extensive burns

doi: 10.3760/cma.j.cn501120-20211109-00383

Abstract

References

Relative Articles

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Establishment and application of the tenfold rehydration formula for emergency resuscitation of adult patients after extensive burns

doi: 10.3760/cma.j.cn501120-20211109-00383

Abstract

References

Relative Articles

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Export File

Citation

Format

Content