This is a prospective, non-interventional, observational study of consecutive burn patients admitted to 20 selected burn centers in North America. Primarily, data collection will be continuous "real-time" documentation of fluid infusion rates, vital signs and laboratory values of patients receiving fluid resuscitation during the first 48 hours following burn injury. All aspects of the resuscitation and all investigations performed will be according to the participating center's regular protocol, as this is purely an observational and non-interventional study. Further data collection on outcomes (organ function, ventilation duration, length of stay, and survival) will be collected at 72h, 96 h, and at hospital discharge.
This is a prospective observational study with no intervention. Study sites have been selected to include wide cross-representation of resuscitation practices using crystalloids alone, crystalloid plus albumin, and among sites that use albumin, variable approaches to the timing of albumin initiation. Detailed data will be continuously collected in "real time" during fluid resuscitation over the 1st 48 hours following a burn injury. Data collection during this phase will be done prospectively, hour-by-hour, by the bedside nurse caring for the patient. Primarily this data collection will involve recording of resuscitation fluid volumes, urinary output, vital signs (heart rate and blood pressure), and use of vasopressors and inotropes. Outcome data (organ function, need for mechanical ventilation, hospital length of stay, and survival) will be collected at various time points during the subjects' acute care stay. At completion of the study we intend to make the following comparisons: 1. Subjects that received crystalloids only compared to subjects that received crystalloids plus albumin. 2. Subjects that had albumin started "early" (\< 8 hours post burn), compared to subjects that had albumin started "intermediate" (8-12 hours post burn), compared to subjects that had albumin started "late" (\>12 hours post burn). 3. Characteristics of resuscitation prior to the start of albumin ("pre-albumin") compared to characteristics of resuscitation following initiation of albumin ("post albumin").
Study Type
OBSERVATIONAL
Enrollment
400
University of California Davis Medical Center-Regional Burn Center
Sacramento, California, United States
Fluid resuscitation volume
Total fluid resuscitation volume in mL/kg/% TBSA (total body surface area) burn
Time frame: 24 hours post burn injury
albumin : crystalloid ratio
albumin : crystalloid ratio ( mL albumin : mL crystalloid, and, grams albumin : mL crystalloid)
Time frame: 24 hours hours post burn injury
Fluid resuscitation volume
Total fluid resuscitation volume in mL/kg/% TBSA burn
Time frame: 48 hours post burn injury
albumin : crystalloid ratio
albumin : crystalloid ratio ( mL albumin : mL crystalloid, and, grams albumin : mL crystalloid)
Time frame: 48 hours post burn injury
I/O Ratio
Total intake and output ratio
Time frame: 24 hours post burn injury
I/O Ratio
Total intake and output ratio
Time frame: 48 hours post burn injury
Doses of vasopressors and inotropes
Total doses of vasopressors and inotropes
Time frame: 24 hours post burn injury
Doses of vasopressors and inotropes
Total doses of vasopressors and inotropes
Time frame: 48 hours post burn injury
Fasciotomy
Documentation of fasciotomy performed
Time frame: during the first 48 hours post burn injury
abdominal compartment syndrome
Occurrence of abdominal compartment syndrome
Time frame: during the first 48 hours post burn injury
completion of resuscitation
Time to completion of resuscitation
Time frame: up to 48 hours post burn injury
AKIN Score (acute kidney injury network)
Acute Kidney Injury Network stage
Time frame: 24 hours post burn injury
AKIN Score
Acute Kidney Injury Network stage
Time frame: 48 hours post burn injury
AKIN Score
Acute Kidney Injury Network stage
Time frame: 72 hours post burn injury
AKIN Score
Acute Kidney Injury Network stage
Time frame: 96 hours post burn injury
SOFA score (sequential organ failure assessment)
Sequential Organ Failure Assessment
Time frame: 24 hours post burn injury
SOFA score
Sequential Organ Failure Assessment
Time frame: 48 hours post burn injury
SOFA score
Sequential Organ Failure Assessment
Time frame: 72 hours post burn injury
SOFA score
Sequential Organ Failure Assessment
Time frame: 96 hours post burn injury
Mechanical Ventilation
Duration of mechanical ventilation and ventilator free days
Time frame: from date of hospital admit until date of hospital discharge, assessed over duration of hospitalization up to 12 months
Hospital Stay
Length of hospital stay
Time frame: from date of hospital admit until date of hospital discharge, assessed over duration of hospitalization up to 12 months
Survival
In hospital and 28 day survival
Time frame: 28 days post burn injury or death, whichever occurs first
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