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Concurrently, researchers showed the hemodynamic effects of fluid resuscitation in burns, which culminated in the Brooke formula. ftey found that fluid resuscitation caused an obligatory 20% decrease in both extracellular fluid and plasma volume that concluded after 24 hours.
The response to fluid resuscitation should be continuously monitored, and adjustments in the rate of fluid administration should be made accordingly.
With the advent of vigorous fluid resuscitation, irreversible burn shock has been replaced by sepsis and subsequent multiorgan failure as the leading cause of death associated with burns.
Oxidative damage from reperfusion after low-flow states makes early, aggressive fluid resuscitation imperative. ftis is particularly important during the initial phases of treatment and operative excision with its attendant blood losses.
Novel concepts and techniques have been proposed and sig- nificantly improved during the past 30 years, resulting in a con- siderable decline in burn-related deaths and hospital admissions in the United States. fte single greatest advancement in treating patients with severe thermal injuries during the last 20 years has probably been early excision and closure of the burn wound, leading to substantially reduced resting energy requirements and subsequent improvement of mortality rates in this particular population of patients. fte adequate and rapid institution of fluid resuscitation maintains tissue perfusion and prevents organ system failure.
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