This is the podcast surgery I see rounds. My name is Jeff Guy. I am the director of the

Burn Center at Vanderbilt and the associate professor of surgery. Today I want to do a journal

of a coloptite review of an article that appeared recently in the Journal of Burn Care and Rehab.

It's an article by Dr. Jeff Saffel, who is a true gentleman and scholar, who is the director

of the Burn Center at the Intermountain,

burn center in Salt Lake City.

He wrote an article called The Phenomena of Fluid Creep and acute burn resuscitation.

And overall, it's a good review of the history, excuse me historical development of the burn resuscitation formulas that we use currently.

Perhaps some of the errors we've made over the decades

with that formula, and discusses some of the problems that we have currently in modern burn

care of fluid creep, edema, excessive edema, and abdominal compartment syndrome.

The development of effective fluid resuscitation regiments is one of the cornerstones of modern

burn treatment and perhaps the advance which has most directly improved patient survival.

Beginning in World War II, patients with even moderate burns often died within a few days,

a progressive shock and renal failure.

In 1921, Underhill's study of the victims of the Rialda Theater fire led him to conclude that

the loss of intravasculary volume led to life-threatening shock state syndrome that could be treated

with infusions of normal sailing.

Then in 1942, following a Coconut Grove fire, Copman Moore designed the first formal

resuscitation regiment that was used to treat the victims of Coconut Grove nightclub fire,

which demonstrated a reduction to mortality. With continued refinement and resuscitation, almost all

patients can now be resuscitated successfully, and renal failure complicating acute burn injury

...