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Date of Award

2016

Document Type

Thesis

Degree Name

Master of Science in Nursing (MSN)

Department

Nursing

Thesis Committee Chairperson

Diane Ryan, PhD, ANP-BC, FNP-BC, GNP-BC, CNE

Second Reader

Audrey Hoerner, MSN, APRN-BC

Keywords

burn resuscitation, crystalloid, colloid, burn patients, parkland formula

Abstract

Background: The debate over burn fluid resuscitation has been an ongoing controversy since the 1940’s. The uncertainty of what fluid therapies are to be initiated within the burn resuscitation phase of patient care has given rise to the use of the routine use of different fluid therapies during the initial 24 hour period. In addition to this lack of uniformity, there is no agreement among providers of as to what protocol and what fluid therapy is most advantageous for this patient population.

Purpose: The purpose of this study is to analyze the effectiveness of crystalloid vs. combination colloid and crystalloid fluid therapy during the burn resuscitation phase.

Methods: A retrospective quantitative research study was conducted analyzing the effectiveness of crystalloid vs. colloid and crystalloid therapy during the burn resuscitation phase. Forty subjects were included in the study. Twenty patients had received Lactated Ringers, while twenty patients had received Lactated Ringers in conjunction with albumin. This study, by means of retrospective analysis, examined the effects of two types of fluid therapies on CVP (central venous pressure) readings and urine output. Data analysis was conducted using SAS Software Version 9.4.

Results: CVP and urine output hydration in relation to fluid therapies were conducted via nonparametric analysis by chi-square tests. Patients who received crystalloid and colloid therapy achieved CVP hydration 90% of the time, while those who received crystalloid therapy only achieved CVP hydration 50% of the time (p = 0.0058). Patients who received crystalloid and colloid therapy achieved urine output hydration 85% of the time, while those who only received crystalloid therapy achieved urine output hydration 55% of the time (p = 0.0384). Logistic regression analysis showed that those who had received the crystalloid and colloid therapy were COLLOID & CRYSTALLOID TREATMENT IN BURN PATIENTS 9 9.5 times more likely to be hydrated than those who had only received crystalloid therapy (OR = 9.47, p = 0.0131). Urine output hydration showed that those on crystalloid and colloid therapy were 4.5 times more likely to be hydrated when compared to those who had received crystalloid therapy alone (OR = 4.52, p = 0.0446).

Conclusions / Implications for Practice: As a result of this study patients achieved a higher optimal hydration status when treated with crystalloid and colloid therapy together. Implications for this study urges the reader to incorporate the use of crystalloid and colloid therapy together and the need for a prospective randomized control trial.

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