FFP Resuscitation in Burn: Are Your Patients Missing Out On This Benefit?
Dec 5, 2022
auto_awesome
In this engaging discussion, burn specialists Robel Beyene, Colonel Jennifer Gurney, and Tina Palmieri explore the innovative use of Fresh Frozen Plasma (FFP) in burn resuscitation. They delve into the historical evolution of plasma-based techniques and the critical importance of timely administration to reduce endothelial damage. The conversation highlights significant advancements and ongoing research that inform better patient care practices. Challenges in current resuscitation metrics and new strategies like enteral nutrition are also examined, shedding light on the future of burn treatment.
The historical context of plasma's use in burn patients demonstrates the need to reassess its role amidst modern resuscitation practices.
Emerging research on innovative resuscitation techniques underscores the importance of timely interventions for improving outcomes in burn trauma.
Deep dives
Historical Context of Plasma-Based Resuscitation
Plasma-based resuscitation has a long history dating back to the 1920s and 1930s, initially utilized during World Wars. Its decline in popularity was attributed to high incidences of hepatitis and adverse reactions associated with fresh frozen plasma administration, particularly due to the pooling of plasma from multiple donors. During the 1950s and 60s, crystalloid solutions became more favored as research indicated their effectiveness in resuscitating burn victims. Despite the setbacks, there is a recognition that understanding the historical context of plasma's use can inform current practices and attitudes toward its reintroduction.
The Importance of Glycocalyx and Endotheliopathy
The glycocalyx plays a critical role in the pathophysiology of burn shock, where endothelial dysfunction can worsen outcomes for burn patients. Research indicates that crystalloid resuscitation might exacerbate the damage to the glycocalyx, thus prompting a reconsideration of plasma as a viable option for restoring plasma volume and stabilizing the endothelium. The panel highlights that the right type of resuscitation fluids is essential due to the unique challenges posed by burn injuries, which often involve significant fluid loss not addressed by crystalloids alone. This understanding emphasizes the need for more tailored interventions in burn treatment protocols.
Resistance to Plasma Resuscitation
Reluctance to adopt plasma resuscitation stems from both historical practices and logistical challenges in modern medical settings. The legacy of the Parkland formula created a foundational resistance to alternatives, reinforcing established protocols over time, even when evidence supporting plasma's use has emerged. Additionally, practical issues such as plasma cost, availability, and resource limitations contribute to institutional hesitation to embrace plasma in burn care. This resistance reflects a complex interplay of historical beliefs, economic constraints, and a lack of widespread clinical evidence to support a shift in practice.
Looking Ahead: Future Directions in Burn Resuscitation
Future research focuses on advancing burn resuscitation techniques, including potential trials on the use of intravenous plasma and enteral nutrition in burn management. Innovations such as lyophilized plasma and the adoption of artificial intelligence to optimize resuscitation parameters are also on the horizon. The discussion highlights the importance of timing in resuscitation efforts, suggesting that benefits from new therapies are most pronounced when administered early. Ultimately, harnessing a holistic approach, including evaluating comprehensive patient responses, is essential for effective burn care and resuscitation strategies.
Join Drs. Cardenas and Dudas discuss the history, role, potential benefits and implementation of FFP resuscitation as a strategy in burn patients with burn specialists Drs. Robel Beyene, Colonel Jennifer Gurney and Tina Palmieri. What other options are being studied and what is on the horizon? Don’t miss this information packed discussion!Supplemental Material: Fellowships - The Eastern Association for the Surgery of Trauma
Get the Snipd podcast app
Unlock the knowledge in podcasts with the podcast player of the future.
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode
Save any moment
Hear something you like? Tap your headphones to save it with AI-generated key takeaways
Share & Export
Send highlights to Twitter, WhatsApp or export them to Notion, Readwise & more
AI-powered podcast player
Listen to all your favourite podcasts with AI-powered features
Discover highlights
Listen to the best highlights from the podcasts you love and dive into the full episode