Fluid resuscitation for major burn patients with the TMMU protocol

Luo, Gaoxing; Peng, Yizhi; Yuan, Zhiqiang; Cheng, Wenguang; Wu, Jun; Tang, Jin; Huang, Yuesheng; Fitzgerald, Mark

doi:10.1016/j.burns.2009.02.020

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Volume 35, Issue 8 , Pages 1118-1123, December 2009

Fluid resuscitation for major burn patients with the TMMU protocol

Gaoxing Luo
- Burn Research Institute, Southwest Hospital, State Key Lab of Trauma, Burn and Combined injury, Third Military Medical University, Chongqing 400038, PR China
- Corresponding authors. Tel.: +86 23 65461677; fax: +86 23 65461677.
Yizhi Peng
- Burn Research Institute, Southwest Hospital, State Key Lab of Trauma, Burn and Combined injury, Third Military Medical University, Chongqing 400038, PR China
Zhiqiang Yuan
- Burn Research Institute, Southwest Hospital, State Key Lab of Trauma, Burn and Combined injury, Third Military Medical University, Chongqing 400038, PR China
Wenguang Cheng
- Burn Research Institute, Southwest Hospital, State Key Lab of Trauma, Burn and Combined injury, Third Military Medical University, Chongqing 400038, PR China
Jun Wu
- Burn Research Institute, Southwest Hospital, State Key Lab of Trauma, Burn and Combined injury, Third Military Medical University, Chongqing 400038, PR China
- Corresponding authors. Tel.: +86 23 65461677; fax: +86 23 65461677.
Jin Tang
- Burn Research Institute, Southwest Hospital, State Key Lab of Trauma, Burn and Combined injury, Third Military Medical University, Chongqing 400038, PR China
Yuesheng Huang
- Burn Research Institute, Southwest Hospital, State Key Lab of Trauma, Burn and Combined injury, Third Military Medical University, Chongqing 400038, PR China
Mark Fitzgerald
- The Alfred Emergency and Trauma Centre, Melbourne, VIC 3004, Australia

Accepted 23 February 2009.

Abstract

Background

Fluid resuscitation is one of the critical treatments for the major burn patient in the early phases after injury. We evaluated the practice of fluid resuscitation for severely burned patients with the Third Military Medical University (TMMU) protocol, which is most widely used in many regions of China.

Methods

Patients with major burns (>30% total body surface area (TBSA)) presenting to Southwest Hospital, Third Military Medical University, between January 2005 and October 2007, were included in this study. Fluid resuscitation was initiated by the TMMU protocol.

Results

A total of 71 patients were (46 adults and 25 children) included in this study. All patients survived the first 48h after injury smoothly and none developed abdominal compartment syndrome or other recognised complications associated with fluid resuscitation. The average quantity of fluid infused was 3.3–61.33% more than that calculated based on the TMMU protocol in both adult and paediatric groups. The average urine output during the first 24h after injury was about 1.2ml per kg body weight per hour in the two groups, but reached 1.2ml and 1.7ml during the second 24h in adult and pediatric groups, respectively.

Conclusion

This study indicates that the TMMU protocol for fluid resuscitation is a feasible option for burn patients. Individualised resuscitation – guided by the physiological response to fluid administration – is still important as in other protocols.

Keywords: Fluid resuscitation, Major burn injury, TMMU protocol, Urine output