EMERGENCY CASEBOOK

The use of a cardiac output monitor to guide the initial fluid resuscitation in a patient with burns

Robert Darren Reid¹, John Jayamaha²

¹ Nottingham University Hospitals NHS Trust, Burton-On-Trent, Staffordshire, UK
² Critical Care Directorate, Nottingham University Hospitals NHS Trust, Nottingham, UK

Correspondence to:
Correspondence to:
Dr R D Reid
Senior House Officer, Critical Care Directorate, Nottingham University Hospitals NHS Trust, City Hospital Campus, Hucknall Road, Nottingham NG5 1PB, UK; darren_reid{at}hotmail.co.uk

A case of initial resuscitation of a patient with severe burns is described. Such patients can have hypotension and reduced organ perfusion for a number of reasons, and can remain in the emergency department for many hours while awaiting transfer to specialist centres. The case provides a comparison between resuscitation using traditional burns formulae and a relatively new and simple-to-use cardiac output (CO) monitor—the Vigileo monitor (Edwards Lifesciences, Irvine, California, USA). The case demonstrates that relying on fluid regimes alone can lead to insufficient resuscitation. We suggest that using technologies such as those mentioned in this article, which have the potential to be used in the emergency department, could improve the initial resuscitation of patients with burns.

Abbreviations: BP, blood pressure; CO, cardiac output; ED, emergency department; SVR, systemic vascular resistance; SVV, stroke volume variation

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This article has been cited by other articles:

• Compton, F. D., Zukunft, B., Hoffmann, C., Zidek, W., Schaefer, J.-H. (2008). Performance of a minimally invasive uncalibrated cardiac output monitoring system (FlotracTM/VigileoTM) in haemodynamically unstable patients. Br J Anaesth 100: 451-456 [Abstract] [Full Text]