Hemodynamic coherence in burn patients

Abstract Burn shock is characterized by profound hemodynamic alterations mainly related to rapid loss of intravascular volume related to severe capillary leak and hypovolemic shock. Thereby, fluid resuscitation is considered as a corner stone of initial management of burn patients conventionally based on macrocirculatory targets. Nonetheless, traditional markers such as blood pressure, urinary output and cardiac output are helpful but do not reflect sufficiently the adequacy of perfusion and oxygenation at the microcirculatory level.Microcirculatory alterations have been identified in severe burn patients even when macrocirculatory variables are within therapeutic goals. In this review, we discuss the pathophysiology of the microvascular alterations in burn shock, its coherence with macrocirculatory physiologic variables and potential future implications for the treatment of burn shock.