Burns Open (Jul 2021)
A randomized prospective comparison of the Baxter and Modified Brooke formulas for acute burn resuscitation
- Daizoh Saitoh,
- Satoshi Gando,
- Kunihiko Maekawa,
- Junichi Sasaki,
- Seitaro Fujishima,
- Hiroto Ikeda,
- Yasukazu Shiino,
- Kiyotsugu Takuma,
- Taka-aki Nakada,
- Katsumi Tanaka,
- Osamu Tasaki,
- Manabu Nemoto,
- Shunsuke Yuzuriha,
- Hiroyuki Yamaguchi,
- Fumiaki Iwase,
- Shigenari Matsuyama,
- Kotaro Matsui,
- Koichiro Yoshimuta,
- Hitoshi Yamamura,
- Nobuyuki Harunari,
- Ken Okamoto,
- Hiroshi Tanaka,
- Daizoh Saitoh,
- Satoshi Gando,
- Kunihiko Maekawa,
- Junichi Sasaki,
- Seitaro Fujishima,
- Hiroto Ikeda,
- Yasukazu Shiino,
- Kiyotsugu Takuma,
- Taka-aki Nakada,
- Katsumi Tanaka,
- Osamu Tasaki,
- Manabu Nemoto,
- Shunsuke Yuzuriha,
- Hiroyuki Yamaguchi,
- Fumiaki Iwase,
- Shigenari Matsuyama,
- Kotaro Matsui,
- Koichiro Yoshimuta,
- Hitoshi Yamamura,
- Nobuyuki Harunari,
- Ken Okamoto,
- Hiroshi Tanaka
Affiliations
- Daizoh Saitoh
- National Defense Medical College, Division of Traumatology, Research Institute, Japan; Corresponding author.
- Satoshi Gando
- Hokkaido University Graduate School of Medicine, Division of Acute and Critical Care Medicine, Department of Acute and Critical Care Medicine, Sapporo Higashi Tokushukai Hospital, Japan
- Kunihiko Maekawa
- Hokkaido University Graduate School of Medicine, Division of Acute and Critical Care Medicine, Department of Acute and Critical Care Medicine, Sapporo Higashi Tokushukai Hospital, Japan
- Junichi Sasaki
- Keio University School of Medicine, Japan
- Seitaro Fujishima
- Keio University School of Medicine, Japan
- Hiroto Ikeda
- Teikyo University School of Medicine, Department of Emergency Medicine, Japan
- Yasukazu Shiino
- Kawasaki Medical School, Department of Acute Medicine, Japan
- Kiyotsugu Takuma
- Kawasaki Municipal Hospital, Emergency & Critical Care Center, Japan
- Taka-aki Nakada
- Chiba University Graduate School of Medicine, Department of Emergency and Critical Care Medicine, Japan
- Katsumi Tanaka
- Nagasaki University Hospital, Japan
- Osamu Tasaki
- Nagasaki University Hospital, Japan
- Manabu Nemoto
- Saitama Medical University International Medical Center, Department of Emergency and Acute Medicine, Japan
- Shunsuke Yuzuriha
- Shinshu University School of Medicine, Department of Plastic and Reconstructive Surgery, Japan
- Hiroyuki Yamaguchi
- Seirei Yokohama General Hospital, Department of Emergency Medicine, Japan
- Fumiaki Iwase
- Yamanashi Prefectural Central Hospital, Advanced Emergency and Critical Care Medical Center, Japan
- Shigenari Matsuyama
- Hyogo Emergency Medical Center, Japan
- Kotaro Matsui
- University of Toyama, Toyama University Hospital, Disaster and Emergency Center, Japan
- Koichiro Yoshimuta
- Kitakyushu General Hospital, Department of Plastic and Reconstructive Surgery, Japan
- Hitoshi Yamamura
- Hirosaki University School of Medicine, Department of Disaster and Critical Care Medicine, Japan
- Nobuyuki Harunari
- Yokohama City University Medical Center, Advanced Critical Care and Emergency Medical Center, Japan
- Ken Okamoto
- Juntendo University Urayasu Hospital, Department of Emergency and Critical Care Medicine, Japan
- Hiroshi Tanaka
- Juntendo University Urayasu Hospital, Department of Emergency and Critical Care Medicine, Japan
- Daizoh Saitoh
- Division of Traumatology, Research Institute, National Defense Medical College, Saitama, Japan; Corresponding author at: Division of Traumatology, Research Institute, National Defense Medical College, Namiki 3-2, Tokorozawa, Saitama 359-8513, Japan.
- Satoshi Gando
- Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Hokkaido, Japan; Department of Acute and Critical Care Medicine, Sapporo Tokushukai Hospital, Hokkaido, Japan
- Kunihiko Maekawa
- Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
- Junichi Sasaki
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan
- Seitaro Fujishima
- Center for General Medicine Education, Keio University School of Medicine, Tokyo, Japan
- Hiroto Ikeda
- Department of Emergency Medicine, Trauma and Resuscitation Center, Teikyo University School of Medicine, Tokyo, Japan
- Yasukazu Shiino
- Department of Acute Medicine, Kawasaki Medical School, Okayama, Japan
- Kiyotsugu Takuma
- Emergency & Critical Care Center, Kawasaki Municipal Hospital, Kanagawa, Japan
- Taka-aki Nakada
- Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
- Katsumi Tanaka
- Department of Plastic and Reconstructive Surgery, Nagasaki University, Nagasaki, Japan
- Osamu Tasaki
- Acute & Critical Care Center, Nagasaki University Hospital, Nagasaki, Japan
- Manabu Nemoto
- Department of Emergency and Acute Medicine, Saitama Medical University International Medical Center, Saitama, Japan
- Shunsuke Yuzuriha
- Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Nagano, Japan
- Hiroyuki Yamaguchi
- Department of Emergency Medicine, Seirei Yokohama General Hospital, Kanagawa, Japan
- Fumiaki Iwase
- Advanced Emergency and Critical Care Medical Center, Yamanashi Prefectural Central Hospital, Yamanashi, Japan
- Shigenari Matsuyama
- Hyogo Emergency Medical Center, Hyogo, Japan
- Kotaro Matsui
- Disaster and Emergency Center, Toyama University Hospital, University of Toyama, Toyama, Japan
- Koichiro Yoshimuta
- Department of Plastic and Reconstructive Surgery, Kitakyushu General Hospital, Fukuoka, Japan
- Hitoshi Yamamura
- Department of Disaster and Critical Care Medicine, Hirosaki University, School of Medicine, Aomori, Japan; Osaka Prefectural Nakakawachi Emergency and Critical Care Center, Osaka, Japan
- Nobuyuki Harunari
- Advanced Critical Care and Emergency Medical Center, Yokohama City University Medical Center, Kanagawa, Japan; Shonan Sanada Medicare Center, Kanagawa, Japan
- Ken Okamoto
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Chiba, Japan
- Hiroshi Tanaka
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Chiba, Japan
- Journal volume & issue
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Vol. 5,
no. 3
pp. 89 – 95
Abstract
Background: Starting infusion at a rate based on the Baxter formula is the global standard. However, with this infusion formula, an excessive amount of fluid may be stored inside the body (fluid creep), which may lead to severe respiratory disorders or abdominal compartment syndrome. The present study explored whether the Baxter formula or the Modified Brooke formula is more beneficial for resuscitation in extensively burned patients. Methods: The study design was a randomized controlled trial. One group received conventional intervention based on the Baxter formula, and the other received intervention using the infusion method by the Modified Brooke formula. Thirty-nine patients were enrolled in this study by admission to each hospital for 3 years. Of the 39 cases, 3 dropped out according to the study protocol, so 36 cases were analyzed, and 17 patients in the Modified Brooke formula group and 19 in the Baxter formula group were used for the analyses in this study. Results: There were no statistically significant differences between the 2 groups in the age, gender, body weight, burn severity, infusion volume required within 2 days after admission, serum creatinine, and acute kidney injury based on the KDIGO guideline within 48 h after arrival at the hospital, daily P/F ratio within 1 week after hospitalization, survival rate on the 28th day, and discharge survival rate. There were no cases of abdominal compartment syndrome during the observation period. The Modified Brooke formula group failed to achieve the target urine output corresponding to the infusion volume within 8 h after arrival, especially in ≥40% TBSA burn patients, but it did not become a clinical problem. Conclusion: We were unable to conclusively demonstrate that the Modified Brooke formula blocked the occurrence of “fluid creep” in extensively burned patients. However, it was suggested that starting the initial resuscitation at half the conventional volume might contribute to an improved physiological condition in the acute phase of major burns.
