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from Section 3 - Practical Use
Published online by Cambridge University Press: 11 April 2024
Severe burn injury induces an early and profound hypovolemia, rapidly followed by a systemic inflammatory response syndrome (SIRS) resulting in a distributive shock.
Cardiovascular consequences of severe burn injury are multiple including burn edema, burn shock, burn-associated cardiac injury and alteration of microcirculation
Hemodynamic targets of critically ill burn patients and goal-directed resuscitation therapy are the cornerstone of initial hemodynamic management.
This resuscitation is challenging with the risk of under- and over-resuscitation justifying an invasive hemodynamic monitoring.
Balanced crystalloids are the most commonly used fluids in severely burned patients; the use of albumin is controversial.
During the distributive phase, norepinephrine is often required 12 to 36 hours post-injury.
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