Burns Clinical Trial
Official title:
An Optimizing of the Resuscitative Patterns by Use of Balanced Crystalloids and Colloids and the Non-Invasive Hemodynamic Monitoring
Fluid Therapy Lithium Dilution Cardiac Output (LIDCO) controlled trial in BURNS (FACT in
BURNS) is a prospective randomized multicentric study.
Introduction: The goal of this trial is the verification, optional upgrading and optimizing
of the resuscitative patterns in light of the new generation of balanced crystalloids and
colloids and, by utilization the non-invasive hemodynamic monitoring LIDCO.
Methods: The extensively burnt patients (age range 18-75 years) with second and the third
degree burns, with TBSA above 15%, with or without inhalation injury will be included to the
study within 2009-2010. The patients meeting inclusion criteria but with an adverse critical
prognosis from the beginning of the hospitalization, with surgically insoluble extent of
burns or the dialyzed patients will be excluded.The patients will be routinely monitored. We
will use the continuous real-time hemodynamic monitoring through transpulmonal lithium
dilution additionally. The monitor Lithium Dilution Cardiac Output (LIDCO) Plus permits
through analysis of the arterial blood pressure trace to acquire items about CO, SVR and DO2
. In fluid resuscitation, we will use a combination of the balanced crystalloids and
synthetic colloids (of the middle molecular weight) in the ratio 2 ml/kg/% TBSA : 1 ml/kg/%
TBSA. The control group will be composed of the patients supervised in a standard way,
volume resuscitated according to the Brooke or Parkland formulas. MAP > 65 torr, urine
output 0,5 ml/kg/h, CI 2,5 - 4,0 l/min/m2, DO2I 500 - 600 ml/min/m2 are the goals.We will
measure the levels of proANP (pro Natriuretic peptide) and Angiotensin Converting Enzyme
(ACE) at artificial ventilated patients. The plasma ACE and proANP concentrations were
measured by commercially available ELISA immunoassays.
Conclusions: We will evaluate the total fluid balance at day 1, 2 and cumulative fluid
balance at day 7, reversal of organ dysfunction according to SOFA score at day 3 and 7 in
both group. The days of invasive ventilatory support, length of ICU stay, ICU survival,
total length of hospital stay and hospital survival are the additional endpoints.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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