Traumacast FFP Resuscitation in Burn: Are Your Patients Missing Out On This Benefit?
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Dec 5, 2022 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.
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Historical Rise And Fall Of Plasma
- Plasma was the dominant burn resuscitation fluid early in the 20th century but fell out of favor due to infectious risk and reactions.
- Crystalloid replaced plasma after animal studies and practical concerns despite some early plasma successes.
Glycocalyx Damage Explains Plasma Benefit
- Burn shock involves endothelial and glycocalyx injury similar to trauma and sepsis.
- Replacing plasma with crystalloids may worsen glycocalyx injury and capillary leak.
Burns Lose Protein-Rich Fluid
- Burn wounds leak not only crystalloid but protein-rich fluid, making crystalloids an incomplete replacement.
- Plasma may better match the composition of what burns lose and thus have physiologic rationale.