Burns
Conditions
Keywords
Cardiac output, Low blood pressure, Total Body Surface Area (TBSA)
Brief summary
The purpose of this study is to describe the use of non-invasive cardiac output monitors (NICOM) in patients with burn injuries and to develop a protocol for NICOM in a burn unit.
Detailed description
Appropriate fluid resuscitation in the first 24 hours after a burn injury directly influences patient outcome and morbidity. Currently, there is some controversy surrounding the over and under-resuscitation and endpoints of resuscitation using older fluid resuscitation formulas in patients with burn injury. The NICOM has been used in the resuscitation of patients with sepsis. The NICOM will be used in patients with burn injury to determine the patient's fluid responsiveness and the need for additional fluid boluses versus medications to increase the patient's blood pressure.
Interventions
The non-invasive cardiac output monitor (NICOM) will be used to tailor fluid management to optimize resuscitation if the patient has an episode of hypotension (defined as systolic blood pressure \<100 or mean arterial pressure \<65). NICOM consists of two electrodes placed on the patient's chest and back and uses bioreactance technology to transduce signals to compute hemodynamic parameters on an associated monitor. The electrodes will remain on the patient for twenty minutes. Once the electrodes are in place the patient's leg will be raised to 45 degrees and the monitor to which the electrodes are attached will generate a number that reflects stroke volume of the heart. The electrodes will be removed once this number is determined.
Sponsors
Emory University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1\) Burn greater than 20% TBSA (total body surface area)
Exclusion criteria
1\) Burn less than 20% TBSA (total body surface area)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total volume of fluid given | 24 hours | The total volume of fluid given to the subjects in the first 24 hours |
| Rate of pressor use | Duration of hospital stay, an expected average of 30 days | Defined as number of subjects that required pressor support (administration of cardiovascular supportive agents) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of pulmonary edema | Duration of hospital stay, an expected average of 30 days | Defined as number of subjects with pulmonary edema |
| Rate of acute renal failure | Duration of hospital stay, an expected average of 30 days | Defined as number of subjects with renal failure |
| Length of stay in intensive care unit (ICU) | 3 months | Defined as the number of days from date of admission to date of first ICU discharge. |
| Length of hospital stay | 3 months | Defined as the number of days from date of admission to date of first hospital discharge, regardless of if subject was discharged to home or other location. |
Countries
United States
Outcome results
None listed