• Maria Helena M Dittrich, Nicole Dittrich Hosni, and Werther B de Carvalho.
• Federal University of São Paulo, Escola Paulista De Medicina, São Paulo, Brazil. Electronic address: dittrich.helena@unifesp.br.
• Burns. 2020 Aug 1; 46 (5): 1036-1042.

IntroductionAggressive fluid resuscitation has been extensively discussed after the establishment of fluid creep phenomenon as a morbidity and mortality factor in burn children. Sepsis is currently the leading cause of death in survivors of burn shock.ObjectivesTo evaluate the association between fluid creep and infection in burn children exposed to two different fluid resuscitation strategies with the use of albumin.MethodsA cohort of 46 burn children with 15-45% of body surface area (BSA) admitted up to 12 h after the incident were evaluated. Patients from early albumin group (n = 23) received 5% albumin between 8 and 12 h from injury and patients from delayed albumin group (n = 23) received 5% albumin after 24 h. Outcomes analysed were development of fluid creep, length of stay in the hospital, number of surgery procedures and infection until hospital discharge.ResultsCompared to the delayed group, patients that received early albumin had a shorter length of stay in the hospital (p = 0.007), less fluid creep (4.3% × 56.5%) (p < 0.001), less skin graft procedure (47.8% × 78.3%) (p = 0.032) and less debridement (73.9% × 100%) (p = 0.022). Both length of stay in the hospital and fluid creep arising were associated with infection (p < 0.05).ConclusionFluid creep, surgery procedures and length of stay in hospital parameters showed better results in burn children treated with early albumin. Fluid creep and length of stay in the hospital were associated with infection, providing a negative prognosis.Copyright © 2020 Elsevier Ltd and ISBI. All rights reserved.

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