ASV and Targeted Fluid Resuscitation in Severe Burns

Severe burn injury is frequently associated with profound systemic inflammation, capillary leak syndrome, hypovolemic shock, inhalation injury, and acute respiratory failure requiring invasive mechanical ventilation. The first 72 hours following injury represent a critical phase during which both ventilatory support and fluid resuscitation substantially influence organ function and subsequent clinical outcomes.

Adaptive Support Ventilation (ASV) is a closed-loop mechanical ventilation mode that automatically adjusts ventilatory parameters according to the patient's respiratory mechanics while maintaining predefined ventilation targets. This approach has the potential to optimize lung-protective ventilation, reduce unnecessary ventilatory stress, and improve patient-ventilator synchrony. At the same time, targeted fluid resuscitation aims to individualize fluid administration based on physiological and clinical parameters in order to maintain adequate tissue perfusion while minimizing fluid overload and the development of burn-related edema.

This prospective cohort study will evaluate the association between the combined use of Adaptive Support Ventilation and targeted fluid resuscitation during the early management of adult patients with severe burn injuries admitted to the intensive care unit. Patients will be managed according to institutional protocols, and no study-specific interventions will be introduced beyond routine clinical practice.

Clinical, respiratory, hemodynamic, and laboratory data will be collected prospectively during the first 72 hours after intensive care unit admission. Ventilatory variables, oxygenation indices, respiratory mechanics, fluid administration, cumulative fluid balance, urine output, and organ dysfunction parameters will be recorded using standard monitoring systems and electronic medical records.

The study aims to characterize the physiological effects of early Adaptive Support Ventilation combined with targeted fluid resuscitation and to evaluate their association with respiratory function, fluid balance, and early clinical outcomes in patients with severe burn injury. The findings are expected to provide real-world evidence to support optimization of intensive care strategies for critically ill burn patients.

• Static Lung Compliance [Срок оценки: Baseline, 24 hours, 48 hours, 72 hours, and day 7 after ICU admission]
• Driving Pressure [Срок оценки: Baseline, 24 hours, 48 hours, 72 hours, and day 7 after ICU admission]
• Cumulative Fluid Balance [Срок оценки: Through day 7 after ICU admission]
• Total Fluid Volume Administered [Срок оценки: First 24 hours, 48 hours, 72 hours, and through day 7 after ICU admission]
• Urine Output [Срок оценки: First 24 hours, 48 hours, 72 hours, and through day 7 after ICU admission]
• Lactate Clearance [Срок оценки: Baseline, 24 hours, 48 hours, 72 hours, and day 7 after ICU admission]
• Vasopressor Requirement [Срок оценки: Through day 7 after ICU admission]
• Mechanical Ventilation Duration During Early ICU Period [Срок оценки: Through day 7 after ICU admission]