What is the primary goal of early fluid resuscitation in burns patient?

Question

BlackTom AI · Accepted Answer

Burns cause a rapid increase in capillary permeability and plasma extravasation, so the immediate concern is restoring intravascular volume to preserve organ perfusion. Early fluid resuscitation therefore aims to replace fluid losses, sustain cardiac output, and ensure adequate tissue oxygen delivery.

Relevant knowledge points and concepts:
- Thermal injury produces a systemic inflammatory response that increases capillary permeability and leads to “third-spacing” of plasma into interstitial and burn tissues, especially during the first 24 hours.
- Loss of intravascular volume reduces preload, cardiac output, and tissue perfusion, risking burn shock and multi‑organ dysfunction.
- Resuscitation strategies (e.g., Parkland formula: 4 mL × body weight (kg) × %TBSA burned, with half given in first 8 hours) are designed to restore circulating volume quickly.
- Clinical endpoints: urine output (adult target ~0.5 mL/kg/hr), mean arterial pressure, heart rate, mental status, and lactate clearance guide ongoing fluid administration.

Step-by-step reasoning:
1. Burn → increased capillary permeability → plasma proteins and fluid move into interstitium.
2. Effective circulating volume falls → reduced venous return → decreased stroke volume and cardiac output.
3. Reduced cardiac output → diminished tissue perfusion → cellular hypoxia and risk of organ failure (burn shock).
4. Early intravenous fluids replace losses, raise intravascular volume, normalize perfusion pressure and oxygen delivery, preventing shock.
5. Monitor urine output and hemodynamics; adjust fluids to maintain targets and avoid under- or over-resuscitation.

Why the correct answer is correct:
Maintaining adequate tissue perfusion and organ function is the primary goal because it directly prevents the life‑threatening consequence of burn-induced hypovolemia (shock) and is the immediate determinant of survival; fluid resuscitation is the intervention that accomplishes this.

Why other options are incorrect:
- Prevent infection: important later, but not the primary immediate goal of fluid resuscitation.
- Improve wound healing: dependent on many factors; secondary to maintaining perfusion.
- Reduce pain: pain control is essential, but fluids primarily target hemodynamics, not analgesia.

Conclusion: The correct answer is “Maintain adequate tissue perfusion and organ function,” which matches the provided answer.

What is the primary goal of early fluid resuscitation in burns patient? 单项选择题

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