Evaluation of the Effectiveness of the Burn Navigator in Improving Resuscitation Outcomes
Abstract
The objective of this 300 patient multi-center observational study was to evaluate resuscitation volumes and outcomes of patients admitted to five verified burn centers who underwent fluid resuscitation utilizing the Burn Navigator (BN), a burn resuscitation clinical decision support tool. A total of 285 patients were eligible for analysis. There was no difference among the centers in terms of average age (45.5 + 16.8 years), BMI(29.2 + 6.9), ISS (21.2 + 12.8), or median TBSA (34 [25.8, 47]). Analysis of patients in the first 24 hours of resuscitation revealed average volumes for primary (crystalloid) and total fluids administered of 4.07 + or - 1.76 mL/kg/TBSA (or 151.48 + or - 77.46 mL/kg), and 4.68 + or - 2.06mL/kg/TBSA (or 175.01 + or - 92.22 mL/kg), respectively. Examining patients who presented in a delayed fashion revealed average volumes for primary and total fluids of 5.28 + or - 2.54mL/kg/TBSA (or 201.11 + or - 106.53 mL/kg), 6.35 + or - 2.95 mL/kg/TBSA (or 244.08 +/- 133.5 mL/kg),respectively. There was a decreased incidence of shock in the BN-guided group (p< 0.05). The BN provides comparable resuscitation volumes of primary crystalloid fluid to the Parkland Formula, recommends total fluid infusion less than the Ivy Index, and was associated with a decreased incidence of shock. Early initiation of the BN device resulted in lower overall fluid volumes. There was a total of 156 resuscitation-related complications reported across the 5 sites with an average incidence of 44.4 percent incidence. For further details, please see attached abstracts and manuscript (pending publication--journal revision stage) listed below. The Burn Navigator appeared to standardize fluid resuscitations across 5 major US burn centers. With primary fluid volumes near the Parkland formula, the device can be utilized effectively in burn centers, and further study should exam the utility of this device infacilities that do not commonly treat burn injuries, as well as the battlefield.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 2021
- Accession Number
- AD1162332
Entities
People
- Josè Salinas
Organizations
- United States Army Institute of Surgical Research