Acute Burn ResUscitation Prospective Multicenter Observational Trial (ABRUPT)
Abstract
After a burn to more than 20% of the body, there is a massive amount of fluid that leaks out of the blood vessels, causing the patient to go into shock. This leaking fluid also causes swelling (edema), and for a patient with extensive burns, the amount of leaking fluid can be massive. Left untreated, anyone who has a burn to greater than 25% of the total body surface area has a high likelihood of dying due to this loss of fluid from the blood vessels. In order to treat such a major amount of fluid loss, physicians provide intravenous fluids in large amounts. There has been a debate as to whether the use of salt-containing fluids are adequate for fluid replacement or whether a fluid that contains albumin (a natural protein produced by the liver and normally found in the body) is better. Albumin solutions are thought to help reduce the amount of fluid leakage and swelling after a burn whereas salt-containing fluids may be more likely to leak out and create more swelling. There has been a debate for decades as to whether albumin or salt solutions should be used in the treatment of burn patients. We would like to perform a study to test whether using albumin or a salt solution is better for the treatment of burn patients. In order to design a proper study, we need to review the treatment practices of burn units throughout North America first. We propose to closely monitor the care and treatment provided to burn patients in the first 48 hours after their injury at approximately 20 burn centers. The information we gather will be used to help design a future prospective, randomized study comparing standard salt-containing fluids versus fluids containing albumin. We believe that albumin will reduce the amounts of fluid given to burn patients and at the same time reduce well-known complications of giving too much fluid, such as swelling. Since the current proposed study is an observational trial, there will be no risk to the patients because we are only monitoring the usual care that they would normally receive. We believe that the information gathered should provide us with enough information to design a study in the future that will answer this debate, once and for all. The current study is designed to be completed within 4 years. Approximately 10% of all Soldiers involved in our recent conflicts sustained burns. Since Soldiers are at high risk for burns, this study would also improve the care of Soldiers and at the same time, the civilian population would also benefit.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1620048
Entities
People
- David G Greenhalgh
Organizations
- United States Army
- University of California, Davis