Journal article
Improved Intraoperative Hemodynamics in Burn Surgery: An Institutional Change to Pediatric-Specific Hemostasis Solutions
Journal of burn care & research, Vol.41(2), pp.289-292
02/19/2020
DOI: 10.1093/jbcr/irz175
PMID: 31633760
Abstract
A cornerstone of burn surgery hemostasis is infiltration of tumescent vasopressor solutions and topical vasoconstrictor-soaked compresses. Studies detailing pediatric-specific concentrations of these solutions are lacking. Our aim was to assess hemodynamic changes after an institutional change in tumescent vasopressor solution and vasopressor-soaked topical compresses for hemostasis management during pediatric burn surgery. Once the institutional change was implemented, cases performed before and after the intervention were reviewed; inclusion criteria included age 0 to 18 years, burn TBSA >= 10%, and surgery length > 50 minutes. Primary outcomes included changes in intraoperative mean arterial pressure, maximum inhaled anesthetic concentration, need for direct-acting vasodilators, estimated blood loss, and need for blood transfusions. Thirty patients were included in the intervention group, and 31 in the control group. There was a significant difference in peak intraoperative blood pressure in the intervention group (21.4%) compared with the control group (48.0%, P =.005). Maximum inhaled anesthetic concentrations were lower in the intervention group (2.5% vs 2.8%, P =.02). Estimated blood loss per TBSA decreased significantly (8.2 ml/1% TBSA vs 1.7, P =.008), as well as blood transfusion rates, with a transfusion rate of 16.7% in the intervention group vs 45.2% in the control group (P =.03). The changes instituted in type and concentration of tumescent solution and vasopressor-soaked topical compresses were associated with improved hemodynamic changes and decreased transfusion rates intraoperatively.
Details
- Title: Subtitle
- Improved Intraoperative Hemodynamics in Burn Surgery: An Institutional Change to Pediatric-Specific Hemostasis Solutions
- Creators
- Marley B. Lawrence - University of North Carolina at Chapel HillDayley S. Keil - University of North Carolina at Chapel HillGregory S. Maves - University of North Carolina at Chapel HillFei Chen - University of North Carolina at Chapel HillSamuel W. Jones - University of North Carolina at Chapel HillHemanth A. Baboolal - University of North Carolina at Chapel Hill
- Resource Type
- Journal article
- Publication Details
- Journal of burn care & research, Vol.41(2), pp.289-292
- Publisher
- Oxford Univ Press
- DOI
- 10.1093/jbcr/irz175
- PMID
- 31633760
- ISSN
- 1559-047X
- eISSN
- 1559-0488
- Number of pages
- 4
- Grant note
- UNC Departments of Anesthesiology, Surgery and Pharmacy
- Language
- English
- Date published
- 02/19/2020
- Academic Unit
- Surgery
- Record Identifier
- 9984756261402771
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