Journal article
The Impact of Opioid Administration on Resuscitation Volumes in Thermally Injured Patients
Journal of burn care & research, Vol.31(1), pp.48-56
2010
DOI: 10.1097/BCR.0b013e3181c7ed30
PMID: 20061837
Abstract
Administration of resuscitation volumes far beyond the estimates established by burn-body weight resuscitation formulas has been well documented. The reasons behind this increase are not clear. We sought to determine if our resuscitation volumes had increased and, if so, what factors were related to their increase. A retrospective chart review identified 154 patients admitted with burns greater than 20% of their BSA during the years of 1975–1976 (period 1), 1990–1991 (period 2), and 2006–2007 (period 3). Charts were reviewed for total fluids (crystalloid, colloid, and blood products) and opioids given before admission, during the first 8 hours of treatment, the next 16 hours of treatment, and the following 24 hours of treatment. Opioids were converted to opioid equivalents (OE). Multiple regression analysis was performed to determine the effects of variables of interest and control for confounders. Significance was assumed at the P < .05 level. Resuscitation fluid volumes increased significantly among adults from 3.97 ml/kg/%BSA during the first period to 6.40 ml/kg/%BSA during the third period (P < .01). The same trend in children <30 kg was not seen (P = .72). Fluid administered during the first 24 hours was significantly associated with age, BSA, intubation, latter two study periods, and opioid administration. Fluid administration was consistently associated with opioid administration at all measured time points. At 24 hours postburn, patients who received 2 to 4 OE/kg required an average of additional 3,650 ± 1,704 ml of fluid, those receiving 4 to 6 OE/kg had required an average of 25,154 ± 4,386 ml, and those who received >6 OE kg had required an average of 32,969 ± 3,982 ml. In this single center retrospective study, we have shown a statistically significant increase in resuscitation fluids (from 1975 to 2007) and an association of resuscitation volumes with opioids. Opioids have been shown to increase resuscitation volumes in critically ill patients through both central and peripheral effects on the cardiovascular system. Because increased fluid resuscitation has been associated with adverse consequences in other studies, further research on alternative pain control strategies in thermally injured patients is warranted.
Details
- Title: Subtitle
- The Impact of Opioid Administration on Resuscitation Volumes in Thermally Injured Patients
- Creators
- Lucy WIBBENMEYER - Departments of Surgery, The University of Iowa Carver College of Medicine, Iowa City, United StatesAndy SEVIER - Departments of Surgery, The University of Iowa Carver College of Medicine, Iowa City, United StatesJunlin Liao - Departments of Surgery, The University of Iowa Carver College of Medicine, Iowa City, United StatesIngrid WILLIAMS - Departments of Surgery, The University of Iowa Carver College of Medicine, Iowa City, United StatesTimothy LIGHT - Departments of Surgery, The University of Iowa Carver College of Medicine, Iowa City, United StatesBarbara LATENSER - Departments of Surgery, The University of Iowa Carver College of Medicine, Iowa City, United StatesRobert LEWIS - Departments of Surgery, The University of Iowa Carver College of Medicine, Iowa City, United StatesPatrick KEALEY - Departments of Surgery, The University of Iowa Carver College of Medicine, Iowa City, United StatesRichard ROSENQUIST - Departments of Anesthesia, The University of Iowa Carver College of Medicine, Iowa City, United States
- Resource Type
- Journal article
- Publication Details
- Journal of burn care & research, Vol.31(1), pp.48-56
- DOI
- 10.1097/BCR.0b013e3181c7ed30
- PMID
- 20061837
- NLM abbreviation
- J Burn Care Res
- ISSN
- 1559-047X
- eISSN
- 1559-0488
- Publisher
- Lippincott Williams & Wilkins; Philadelphia, PA
- Language
- English
- Date published
- 2010
- Academic Unit
- Surgery; Injury Prevention Research Center
- Record Identifier
- 9984051505702771
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