An Assessment of Research Priorities to Dampen the Pendulum Swing of Burn Resuscitation. Journal Article

Authors: Burmeister, DM; Smith, SL; Muthumalaiappan, K; Hill, DM; Moffatt, LT; Carlson, DL; Kubasiak, JC; Chung, KK; Wade, CE; Cancio, LC; Shupp, JW
Article Title: An Assessment of Research Priorities to Dampen the Pendulum Swing of Burn Resuscitation.
Abstract: On June 17-18, 2019, the American Burn Association, in conjunction with Underwriters Laboratories, convened a group of experts on burn and inhalation injury in Washington, DC. The goal of the meeting was to identify and discuss strategies to optimize the process of burn resuscitation. Patients who sustain a large thermal injury (involving >20% of the total body surface area [TBSA]) face a sequence of challenges, beginning with burn shock. Over the last century, research has helped elucidate much of the underlying pathophysiology of burn shock, which places multiple organ systems at risk of damage or dysfunction. These studies advanced the understanding of the optimal use of fluids for resuscitation. The resultant practice of judicious and timely infusion of crystalloids has likely improved mortality after major thermal injury. However, much remains unclear about how to further improve and customize resuscitation practice to limit the morbidities associated with edema and volume overload. Herein, we review the history and pathophysiology of shock following thermal injury, and propose some of the priorities for resuscitation research. Recommendations include: studying the utility of alternative endpoints to resuscitation, re-examining plasma as a primary or adjunctive resuscitation fluid, and applying information about inflammation and endotheliopathy to target the underlying causes of burn shock. Undoubtedly, these future research efforts will require a concerted effort from the burn and research communities.
Journal Title: Journal of burn care research : official publication of the American Burn Association
ISSN: 1559-0488; 1559-047X
Publisher: Unknown  
Date Published: 2020
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