Fluid Resuscitation in Patients With Severe Burns: A Meta-analysis of Randomized Controlled Trials.
Academic Emergency Medicine · 2017-10-13 · Meta-analysis
Abstract
OBJECTIVES: Fluid resuscitation is the mainstay treatment to reconstitute intravascular volume and maintain end-organ perfusion in patients with severe burns. The use of a hyperosmotic or isoosmotic solution in fluid resuscitation to manage myocardial depression and increased capillary permeability during burn shock has been debated. We conducted a systematic review and meta-analysis to compare the efficacies of hyperosmotic and isoosmotic solutions in restoring hemodynamic stability after burn injuries. METHODS: PubMed, Embase, Cochrane Library, Scopus, and ClinicalTrials.gov registry were searched. Randomized control trials evaluating the efficacy and safety of hyperosmotic and isoosmotic fluid resuscitation in patients with burn injuries were selected. Eligible trials were abstracted and assessed for the risk of bias by two reviewers and results of hemodynamic indicators in the included trials were analyzed. RESULTS: Ten trials including 502 participants were published between 1983 and 2013. Compared with isoosmotic group, the hyperosmotic group exhibited a significant decrease in the fluid load (vol/% total body surface area [TBSA]/weight) at 24 hours postinjury, with a mean difference of -0.54 (95% confidence interval = -0.92 to -0.17). No differences were observed in the urine output, creatinine level, and mortality at 24 hours postinjury between groups. CONCLUSIONS: Hyperosmotic fluid resuscitation appears to be an attractive choice for severe burns in terms of TBSA or burn depth. Further investigation is recommended before conclusive recommendation.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Crystalloids · Fluids & blood · Mortality & survival
Related articles
- Oral/enteral fluid resuscitation in the initial management of major burns: A systematic review and meta-analysis of human and animal studies. (Burns Open, 2024)
- Prehospital fluid resuscitation in patients with severe burns - A nationwide cohort study. (Burns, 2026)
- Comparison of effect of Ringer's lactate and isotonic bicarbonate combination therapy with Ringer's lactate alone in early fluid resuscitation of burns patients - A randomised controlled trial. (Burns, 2025)
- Prehospital treatment of severely burned patients: a retrospective analysis of patients admitted to the Berlin burn centre. (Scand J Trauma Resusc Emerg Med, 2024)
- The Importance of the "Damage Control" Strategy in Multiple Organ Injuries, Pathophysiology and Principles of Hemorrhage Control. (J Clin Med, 2026)
- Effectiveness of plasma versus crystalloids in pre-hospital hemorrhagic shock: systematic review and meta-analysis (Emergency Care Journal, 2026)