Evaluation of the ""Early"" Use of Albumin in Children with Extensive Burns: A Randomized Controlled Trial

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art_DITTRICH_Evaluation_of_the_Early_Use_of_Albumin_in_2016.PDF (483.52 KB)
Citações na Scopus
38
Tipo de produção
article
Data de publicação
2016
Editora
LIPPINCOTT WILLIAMS & WILKINS
DOI
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Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
DITTRICH, Maria Helena Muller
LAVADO, Edson Lopes
Autor de Grupo de pesquisa
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Citação
PEDIATRIC CRITICAL CARE MEDICINE, v.17, n.6, p.E280-E286, 2016
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objective: To compare early versus delayed albumin resuscitation in children with burns in terms of clinical outcome and response. Design: Randomized controlled trial. Setting: Burn center at a tertiary care teaching hospital. Patients: Forty-six children aged 1-12 years with burns greater than 15-45% total body surface area admitted within 12 hours of burn injury. Interventions: Fluid resuscitation was based on the Parkland formula (3 mL/kg/% total body surface area), adjusted according to urine output. Patients received 5% albumin solution between 8 and 12 hours post burn in the intervention group (n = 23) and 24 hours post burn in the control group (n = 23). Both groups were assessed for reduction in crystalloid fluid infusion during resuscitation, development of fluid creep, and length of hospital stay. Measurements and Main Results: There was no difference between groups regarding age, weight, sex, % total body surface area, cause of burn, or severity scores. The median crystalloid fluid volume required during the first 3 days post burn was lower in the intervention than in the control group (2.04 vs 3.05 mL/kg/% total body surface area; p = 0.025 on day 1; 1.2 vs 1.71 mL/kg/% total body surface area; p = 0.002 on day 2; and 0.82 vs 1.3 mL/kg/% total body surface area; p = 0.002 on day 3). The median urine output showed no difference between intervention and control groups (2.1 vs 2.0 mL/kg/hr; p = 0.152 on day 1; 2.58 vs 2.54 mL/kg/hr; p = 0.482 on day 2; and 2.9 vs 3.0 mL/kg/hr; p = 0.093 on day 3). Fluid creep was observed in 13 controls (56.5%) and in one patient (4.3%) in the intervention group. The median length of hospital stay was 18 days (range, 15-21 d) for controls and 14 days (range, 10-17 d) in the intervention group (p = 0.004). Conclusions: Early albumin infusion in children with burns greater than 15-45% total body surface area reduced the need for crystalloid fluid infusion during resuscitation. Significantly fewer cases of fluid creep and shorter hospital stay were also observed in this group of patients.
Palavras-chave
albumins, burns, colloids, edema, pediatrics, randomized controlled trial, resuscitation
URI
https://observatorio.fm.usp.br/handle/OPI/16260
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MPE
Artigos e Materiais de Revistas Científicas - LIM/36