Bibliographic record
Abstract
Fluid creep was recognized nearly a decade ago. Although many burn centers are now aware of fluid creep, it is not clear whether any reversal of this phenomenon has occurred. The purpose of this study was to examine whether we have made any headway in reversing fluid creep at our facility. This is a retrospective review of the first 48 hours of fluid resuscitation using the Parkland formula among patients with >/=15% TBSA burns admitted to our adult regional burn centre (BC) between January 1, 2000, and May 30, 2008. All values are reported as the mean +/- SD. There were 196 consecutive resuscitations available for analysis. Group characteristics were age 46 +/- 18 years, burn size 31% +/- 15% (range 15-81%), and full-thickness burn size 13% +/- 16%, with a 26% incidence of inhalation injury. The delay between injury and BC admission was 4.5 +/- 2.6 hours. During this time, a total crystalloid volume of 1.5 +/- 1.0 ml/kg/%burn, or nearly 40% of the recommended 24-hour Parkland volume, was administered. Total crystalloids given in the first 24 hours (prior to and within the BC) were 6.3 +/- 2.9 ml/kg/%TBSA, with 76% of all resuscitations receiving >4.3 ml/kg/%burn (the upper limit predicted by Baxter). Hourly urine output (UO) in the first 24 hours postburn was 1.2 +/- 0.7 ml/kg/h. There were minimal insignificant downward trends in the volume of resuscitation fluids and the mean hourly UO of the 194 cases over the 8-year period of the study. In contrast, use of colloids (5% albumin) and formal measurement of intraabdominal pressures increased during the same time period. Despite awareness of fluid creep, we have not substantially reversed this phenomenon, primarily because of failure to titrate down fluid infusion rates and by accepting higher than recommended UO. Excessive pre-BC fluid also continues to be a contributing factor.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.003 | 0.007 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".