Abstract
Introduction: While the resuscitation of either a burn or trauma patient is challenge, it is significantly complicated in a patient that has both severe burns and concomitant traumatic injuries. These patients represent a special subgroup that requires not only resuscitation of their burn injuries but also management of underlying traumatic injuries while avoiding complications of over resuscitation. The purpose of this study is to compare patients with concomitant burn and traumatic injuries to patients with isolated burn injuries to identify whether traditional burn resuscitation with crystalloid use leads to significant differences in morbidity and mortality.
Methods: This is case-control retrospective chart review of patients treated at the Arizona Burn Center, Phoenix AZ, from January 2014 to December 2019. Patients with concomitant burn and trauma injuries (Mixed) were matched with isolated burn patients (Burn) based on age, gender, TBSA, total injury severity score, burn injury severity score, and presence of inhalation injury. These groups were then compared to evaluate amount of crystalloid, colloid, and blood products received for the first 72 hours post injury. To determine the impact of fluid resuscitation, groups were then compared with respect to inpatient complications, ventilator days, ICU days, length of stay, and mortality.
Results: 133 patients were noted to have concomitant trauma and burn injuries during the allotted study period. 18 of these patients meet inclusion criteria and were subsequently matched with 18 isolated burn patients for total of 36 patients. Mixed group received more blood products during the first 24 hours of resuscitation (923.83 +1733.25 vs. 74.72 + 217.68, p value <0.05). Overall, mixed and burn patient groups received similar amounts of total fluid products. No significant differences were found when comparing inpatient complications or patient outcomes.
Conclusions: This study suggests that, while blood administration may play a role in concomitant trauma burn patients in first 24 hours of resuscitation, overall these patients require similar amounts of crystalloid and colloid products as burn with no increase in incidence of complications or adverse outcomes.