Email Alerts
RSS
Volume 39 Issue 1
Jan.  2023
Turn off MathJax
Article Contents
Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2023  >  39(1): 59-64
Shen CA,Liu XZ,Xie XY,et al.Establishment and application of the ten-fold rehydration formula for emergency resusof pediatric patients after extensive burns[J].Chin J Burns Wounds,2023,39(1):59-64.DOI: 10.3760/cma.j.cn501120-20211111-00384.
Citation: Shen CA,Liu XZ,Xie XY,et al.Establishment and application of the ten-fold rehydration formula for emergency resusof pediatric patients after extensive burns[J].Chin J Burns Wounds,2023,39(1):59-64.DOI: 10.3760/cma.j.cn501120-20211111-00384.
shu

Establishment and application of the ten-fold rehydration formula for emergency resuscitation of pediatric patients after extensive burns

doi: 10.3760/cma.j.cn501120-20211111-00384

  • 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, 82272279

Major Program of Military Logistics Research Plan ALB18J001

Major Program of Healthcare Special Project 22BJZ35

More Information
    Abstract
  •   Objective  To investigate the scientificity and feasibility of the ten-fold rehydration formula for emergency resuscitation of pediatric patients after extensive burns.  Methods  A retrospective observational study was conducted. The total burn area of 30%-100% total body surface area (TBSA) and body weight of 6-50 kg in 433 pediatric patients (250 males and 183 females, aged 3 months to 14 years) with extensive burns who met the inclusion criteria and admitted to the burn departments of 72 Class A tertiary hospitals were collected. The 6 319 pairs of simulated data were constructed after pairing each body weight of 6-50 kg (programmed in steps of 0.5 kg) and each total burn area of 30%-100% TBSA (programmed in steps of 1%TBSA). They were put into three accepted pediatric rehydration formulae, namely the commonly used domestic pediatric rehydration formula for burn patients (hereinafter referred to as the domestic rehydration formula), the Galveston formula, and the Cincinnati formula, and the two rehydration formulae for pediatric emergency, namely the simplified resuscitation formula for emergency care of patients with extensive burns proposed by the World Health Organization's Technical Working Group on Burns (TWGB, hereinafter referred to as the TWGB formula) and the pediatric ten-fold rehydration formula proposed by the author of this article--rehydration rate (mL/h)=body weight (kg) × 10 (mL·kg-1·h-1) to calculate the rehydration rate within 8 h post injury (hereinafter referred to as the rehydration rate). The range of the results of the 3 accepted pediatric rehydration formulae ±20% were regarded as the reasonable rehydration rate, and the accuracy rates of rehydration rate calculated using the two pediatric emergency rehydration formulae were compared. Using the maximum burn areas (55% and 85% TBSA) corresponding to the reasonable rehydration rate calculated by the pediatric ten-fold rehydration formula at the body weight of 6 and 50 kg respectively, the total burn area of 30% to 100% TBSA was divided into 3 segments and the accuracy rates of the rehydration rate calculated using the 2 pediatric emergency rehydration formulae in each segment were compared. When neither of the rehydration rates calculated by the 2 pediatric emergency rehydration formulae was reasonable, the differences between the two rehydration rates were compared. The distribution of 433 pediatric patients in the 3 previous total burn area segments was counted and the accuracy rates of the rehydration rate calculated using the 2 pediatric emergency rehydration formulae were calculated and compared. Data were statistically analyzed with McNemar test.  Results  Substitution of 6 319 pairs of simulated data showed that the accuracy rates of the rehydration rates calculated by the pediatric ten-fold rehydration formula was 73.92% (4 671/6 319), which was significantly higher than 4.02% (254/6 319) of the TWGB formula (χ2=6 490.88,P<0.05). When the total burn area was 30%-55% and 56%-85% TBSA, the accuracy rates of the rehydration rates calculated by the pediatric ten-fold rehydration formula were 100% (2 314/2 314) and 88.28% (2 357/2 670), respectively, which were significantly higher than 10.98% (254/2 314) and 0 (0/2 670) of the TWGB formula (with χ2 values of 3 712.49 and 4 227.97, respectively, P<0.05); when the total burn area was 86%-100% TBSA, the accuracy rates of the rehydration rates calculated by the pediatric ten-fold rehydration formula and the TWGB formula were 0 (0/1 335). When the rehydration rates calculated by the 2 pediatric emergency rehydration formulae were unreasonable, the rehydration rates calculated by the pediatric ten-fold rehydration formula were all higher than those of the TWGB formula. There were 93.07% (403/433), 5.77% (25/433), and 1.15% (5/433) patients in the 433 pediatric patients had total burn area of 30%-55%, 56%-85%, and 86%-100% TBSA, respectively, and the accuracy rate of the rehydration rate calculated using the pediatric ten-fold rehydration formula was 97.69% (423/433), which was significantly higher than 0 (0/433) of the TWGB formula (χ2=826.90, P<0.05).  Conclusions  The application of the pediatric ten-fold rehydration formula to estimate the rehydration rate of pediatric patients after extensive burns is more accurate and convenient, superior to the TWGB formula, suitable for application by front-line healthcare workers that are not specialized in burns in pre-admission rescue of pediatric patients with extensive burns, and is worthy of promotion.

     

    • FullText(HTML)
  • loading
    • References(23)
  • [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]
    杨宗城. 烧伤治疗学[M]. 3版. 北京: 人民卫生出版社,2006.
    [3]
    RomanowskiKS,PalmieriTL.Pediatric burn resuscitation: past, present, and future[J/OL].Burns Trauma,2017,5:26[2022-12-20]. https://pubmed.ncbi.nlm.nih.gov/28879205/. DOI: 10.1186/s41038-017-0091-y.
    [4]
    PisanoC, FabiaR, ShiJ,et al. Variation in acute fluid resuscitation among pediatric burn centers [J]. Burns, 2021,47(3):545-550. DOI: 10.1016/j.burns.2020.04.013.
    [5]
    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.
    [6]
    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.
    [7]
    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-e439.DOI: 10.1097/BCR.0000000000000304.
    [8]
    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.
    [9]
    申传安. 危重烧伤救治新技术体系[M]. 北京:人民卫生出版社,2021:40-41.
    [10]
    BenickeM,PerbixW,LeferingR,et al.New multifactorial burn resuscitation formula offers superior predictive reliability in comparison to established algorithms[J].Burns,2009,35(1):30-35.DOI: 10.1016/j.burns.2008.06.006.
    [11]
    World Health OrganizationBurns2018-03-06https://www.who.int/en/news-room/fact-sheets/detail/burn

    World Health Organization.Burns[EB/OL].[2018-03-06].https://www.who.int/en/news-room/fact-sheets/detail/burn.
    [12]
    程文凤,赵东旭,申传安,等.14岁以下儿童大面积烧伤的多中心流行病学调查[J].中华医学杂志,2017,97(6):462-467.DOI: 10.3760/cma.j.issn.0376-2491.2017.06.013.
    [13]
    ArbuthnotMK,GarciaAV.Early resuscitation and management of severe pediatric burns[J].Semin Pediatr Surg,2019,28(1):73-78.DOI: 10.1053/j.sempedsurg.2019.01.013.
    [14]
    YakupuA,ZhangJ,DongW,et al.The epidemiological characteristic and trends of burns globally[J].BMC Public Health,2022,22(1):1596.DOI: 10.1186/s12889-022-13887-2.
    [15]
    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.
    [16]
    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.
    [17]
    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.
    [18]
    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.
    [19]
    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.
    [20]
    JeschkeMG,HerndonDN.Burns in children: standard and new treatments[J].Lancet,2014,383(9923):1168-1178.DOI: 10.1016/S0140-6736(13)61093-4.
    [21]
    StrobelAM,FeyR.Emergency care of pediatric burns[J].Emerg Med Clin North Am,2018,36(2):441-458.DOI: 10.1016/j.emc.2017.12.011.
    [22]
    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.
    [23]
    LVKY,XiaZF, ZhangLM,et al.Epidemiology of pediatric burns requiring hospitalization in China: a literature review of retrospective studies[J].Pediatrics,2008,122(1):132-142.DOI: 10.1542/peds.2007-1567.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    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

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (279) PDF downloads(52) Cited by()
    Proportional views
    Related

    Copyright © Chinese Journal of Burns京ICP备07035254号-14

    E-mail：shaoshangzazhi@163.com

    Website：https://zhsszz.xml-journal.net/

    Supported by: Beijing Renhe Information Technology Co. Ltd    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return