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Inhalational burn

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https://www.readbyqxmd.com/read/28697050/transfusion-requirement-in-burn-care-evaluation-tribe-a-multicenter-randomized-prospective-trial-of-blood-transfusion-in-major-burn-injury
#1
Tina L Palmieri, James H Holmes, Brett Arnoldo, Michael Peck, Bruce Potenza, Amalia Cochran, Booker T King, William Dominic, Robert Cartotto, Dhaval Bhavsar, Nathan Kemalyan, Edward Tredget, Francois Stapelberg, David Mozingo, Bruce Friedman, David G Greenhalgh, Sandra L Taylor, Brad H Pollock
OBJECTIVE: Our objective was to compare outcomes of a restrictive to a liberal red cell transfusion strategy in 20% or more total body surface area (TBSA) burn patients. We hypothesized that the restrictive group would have less blood stream infection (BSI), organ dysfunction, and mortality. BACKGROUND: Patients with major burns have major (>1 blood volume) transfusion requirements. Studies suggest that a restrictive blood transfusion strategy is equivalent to a liberal strategy...
July 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28697018/the-renaissance-man-of-burn-surgery-basil-a-pruitt-jr
#2
Karel D Capek, Guillermo Foncerrada, R Patrick Clayton, Michaela Sljivich, Charles D Voigt, Gabriel Hundeshagen, Janos Cambiaso-Daniel, Craig Porter, Ashley Guillory, David N Herndon
Dr. Basil A. Pruitt Jr., a consummate clinical and translational surgeon-scientist, has been spent over half a century at the forefront of an advancing standard of burn care. Commanding the US Army Institute for Surgical Research in San Antonio, he trained generations of leading burn clinicians and allied scientists. At his direction, there were forged discoveries in resuscitation from shock, treatment of inhalation injury, control of burn-related infections, prevention of iatrogenic complications, and understanding the sympathetic, endocrine, and immune responses to burn injury...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28697015/the-p50-research-center-in-perioperative-sciences-how-the-investment-by-the-national-institute-of-general-medical-sciences-in-team-science-has-reduced-post-burn-mortality
#3
Celeste C Finnerty, Karel Capek, Charles Voigt, Gabriel Hundeshagen, Janos Cambiaso-Daniel, Craig Porter, Linda E Sousse, Amina El Ayadi, Ramon Zapata-Sirvent, Ashley Guillory, Oscar E Suman, David N Herndon
Since the inception of the P50 Research Center in Peri-Operative Sciences (RCIPS) funding mechanism, the National Institute for General Medical Sciences has supported a team approach to science. Many advances in critical care, particularly burns, have been driven by RCIPS teams. In fact, burns that were fatal in the early 1970s, prior to the inception of the P50 RCIPS program, are now routinely survived as a result of the P50-funded research. The advances in clinical care that led to the reduction in post-burn death were made by optimizing resuscitation, incorporating early excision and grafting, bolstering acute care including support for inhalation injury, modulating the hypermetabolic response, augmenting the immune response, incorporating aerobic exercise, and developing anti-scarring strategies...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28668540/a-randomized-controlled-trial-of-budesonide-versus-acetazolamide-for-the-prevention-of-acute-mountain-sickness
#4
Grant S Lipman, David Pomeranz, Patrick Burns, Caleb Phillips, Mary Cheffers, Kristina Evans, Carrie Jurkiewicz, Nick Juul, Peter Hackett
BACKGROUND: Inhaled budesonide has been suggested as a novel prevention for acute mountain sickness. However, efficacy has not been compared to the standard acute mountain sickness prevention medication acetazolamide. METHODS: This double-blind, randomized, placebo-controlled trial compared inhaled budesonide to oral acetazolamide to placebo, starting the morning of ascent from 1,240 m (4,100 ft) to 3,810 m (12,570 ft) over 4 hours. The primary outcome was acute mountain sickness incidence (headache and Lake Louise Questionnaire ≥ 3 and another symptom)...
June 13, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28661978/prone-positioning-of-the-burn-patient-with-acute-respiratory-distress-syndrome-a-review-of-the-evidence-and-practical-considerations
#5
Brandon Oto, Rowena I Orosco, Elizabeth Panter, Rama Velamuri, A Reema Kar, Julie Caffrey
Acute respiratory distress syndrome (ARDS) is a common sequela of severe burns and inhalation injury. The massive inflammatory reaction that follows deep burn injury, compounded by episodes of sepsis and organ dysfunction, predisposes patients to the development of ARDS. Prone positioning as a means of improving gas exchange has shown benefit in refractory cases of ARDS, but it is not well described in the burn population. We present a case report of a patient with severe ARDS who underwent prone positioning, review the relevant literature, and provide a discussion of practical concerns...
June 21, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28661975/interleukin-6-serum-levels-correlate-with-severity-of-burn-injury-but-not-with-gender
#6
Stephan Hager, Ann Christina Foldenauer, Hans-Oliver Rennekampff, Robert Deisz, Ruedger Kopp, Mayer Tenenhaus, Marx Gernot, Norbert Pallua
Gender-specific differences in the outcome of patients with burn injury have been recognized in the past with female patients being at a higher risk of mortality. We hypothesized that early post-burn interleukin-6 (IL-6) cytokine levels may contribute to the different gender-specific outcome. We retrospectively examined 94 burned patients who were treated in the Burn Intensive Care Unit at the University Hospital Aachen. Age, gender, presence of inhalation injury, depth, TBSA, and clinical outcome were documented...
June 21, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28657174/effect-of-the-leaf-essential-oil-from-cinnamosma-madagascariensis-danguy-on-pentylenetetrazol-induced-seizure-in-rats
#7
Rianasoambolanoro Rakotosaona, Emmanuel Randrianarivo, Philippe Rasoanaivo, Marcello Nicoletti, Giovanni Benelli, Filippo Maggi
In the Malagasy traditional practices, smoke from burning leaves of Cinnamosma madagascariensis Danguy is inhaled to treat brain disorders such as dementia, epilepsy and headache. In the present work we have evaluated the in vivo anticonvulsant effects of the essential oil from leaves of C. madagascariensis (CMEO). CMEO was isolated by steam distillation. The anticonvulsant activity of CMEO (0.4 and 0.8 mL/kg bw) administered subcutaneously was evaluated on pentylenetetrazol (PTZ)-induced seizures in Wistar rats; diazepam was used as positive control...
June 28, 2017: Chemistry & Biodiversity
https://www.readbyqxmd.com/read/28654804/fatal-and-non-fatal-burn-injuries-with-electrical-weapons-and-explosive-fumes
#8
Mark W Kroll, Mollie B Ritter, Howard E Williams
INTRODUCTION: While generally reducing morbidity and mortality, electrical weapons have risks associated with their usage, including eye injuries and falls. With the presence of explosive fumes or fuels there also exists the possibility of burn injury. METHODS: We searched for cases of fatal and non-fatal major burns with TASER(®) electrical weapon usage where there was a possibility that the weapon ignited the explosion. RESULTS: We confirmed 6 cases of fatal burn injury and 4 cases of major non-fatal burns out of 3...
June 20, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28651419/-significance-of-evaluating-the-severity-of-patients-with-extremely-severe-burn-by-platelet-count-recovery-in-the-early-stage-post-burn
#9
Y Wu, Q Zhang, J Liu, J J Tang, J X Zheng, M Liu
Objective: To retrospectively analyze the prognostic value of platelet count recovery in the early stage post burn for patients with extremely severe burn, so as to evaluate their severity. Methods: A study involving 244 adult patients with extremely severe burn admitted to our hospital from January 2006 to December 2015, conforming to the inclusion criteria, was conducted. Data of their demography, injury, transmission, disease change in hospital, and platelet count from post injury day (PID) 1 to 10 were collected...
May 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28649575/ecmo-in-major-burn-patients-feasibility-and-considerations-when-multiple-modes-of-mechanical-ventilation-fail
#10
Jason D Kennedy, Wesley Thayer, Reuben Beuno, Kelly Kohorst, Avinash B Kumar
BACKGROUND: We report two cases of acute respiratory distress syndrome in burn patients who were successfully managed with good outcomes with extra corporeal membrane oxygenation (ECMO) after failing multiple conventional modes of ventilation, and review the relevant literature. CASE PRESENTATION: The two patients were a 39-year-old male and 53-year-old male with modified Baux Scores of 79 and 78, respectively, with no known inhalation injury. After the initial modified Parkland-based fluid resuscitation and partial escharotomy, both patients developed worsening hypoxemia and acute respiratory distress syndrome...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28644205/the-unrecognized-epidemic-of-electronic-cigarette-burns
#11
Jesus I Ramirez, Catherine A Ridgway, Jeanne G Lee, Bruce M Potenza, Soman Sen, Tina L Palmieri, David G Greenhalgh, Pirko Maguina
Electronic cigarettes (e-cigarettes) are novel battery-operated devices that deliver nicotine as an inhaled aerosol. They originated from China in 2007 and their use has rapidly increased worldwide in the past decade, yet they remain largely unregulated. Reports of injuries associated with their use have appeared as unusual events in the news media and as case reports in the medical literature. This study was undertaken to explore e-cigarettes as a mechanism of burn injury. Referral records to three burn centers from January 2007 to July 2016 were searched to identify patients with injuries caused by e-cigarettes...
July 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28642142/epidemiology-and-outcomes-of-bloodstream-infections-in-177-severe-burn-patients-from-an-industrial-disaster-a-multicenter-retrospective-study
#12
Chenqi Tang, Junqiang Li, Beiming Shou, Bohan Pan, Tiansheng Chen, Yongqiang Xiao, Xiaopeng Zheng, Shichu Xiao, Qian Tan, Zhaofan Xia
OBJECTIVES: To determine the characteristics of bloodstream infections (BSIs) and to evaluate the impact of BSIs on mortality in severe burn patients. METHODS: A retrospective observational study was conducted in 20 tertiary hospitals. A total of 185 Patients who experienced a massive dust explosion in eastern China were included. RESULTS: After exclusion, 177 patients were analyzed. The median total body surface area (TBSA) burned was 95% (interquartile range [IQR], 85%-98%)...
June 19, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28641278/astragaloside-iv-alleviates-heat-induced-inflammation-by-inhibiting-endoplasmic-reticulum-stress-and-autophagy
#13
Zhiwei Dong, Jian Zhou, Ying Zhang, Yajie Chen, Zichen Yang, Guangtao Huang, Yu Chen, Zhiqiang Yuan, Yizhi Peng, Tongtong Cao
BACKGROUND: Thermal injury is the main cause of pulmonary disease in stroke after burn and can be life threatening. Heat-induced inflammation is an important factor that triggers a series of induces pathological changes. However, this mechanism underlying heat-induced inflammation in thermal inhalation injury remains unclear. Studies have revealed that astragaloside-IV (AS-IV), a natural compound extracted from Astragalus membranaceus, has protective effects in inflammatory diseases. Here, we investigated whether the protective effects of AS-IV occur because of the suppression of heat-induced endoplasmic reticulum (ER) stress and excessive autophagy Methods: AS-IV was administered to Wistar rats after thermal inhalation injury and 16HBE140-cells were treated with AS-IV...
2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28615047/sensitivity-to-sevoflurane-anesthesia-is-decreased-in-mice-with-a-congenital-deletion-of-guanylyl-cyclase-1-alpha
#14
Yasuko Nagasaka, Martin Wepler, Robrecht Thoonen, Patrick Y Sips, Kaitlin Allen, Jan A Graw, Vincent Yao, Sara M Burns, Stefan Muenster, Peter Brouckaert, Keith Miller, Ken Solt, Emmanuel S Buys, Fumito Ichinose, Warren M Zapol
BACKGROUND: Volatile anesthetics increase levels of the neurotransmitter nitric oxide (NO) and the secondary messenger molecule cyclic guanosine monophosphate (cGMP) in the brain. NO activates the enzyme guanylyl cyclase (GC) to produce cGMP. We hypothesized that the NO-GC-cGMP pathway contributes to anesthesia-induced unconsciousness. METHODS: Sevoflurane-induced loss and return of righting reflex (LORR and RORR, respectively) were studied in wild-type mice (WT) and in mice congenitally deficient in the GC-1α subunit (GC-1(-/-) mice)...
June 14, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28606748/long-term-mortality-in-critically-ill-burn-survivors
#15
Stephanie Nitzschke, Anaeze C Offodile, Ryan P Cauley, Jason E Frankel, Andrew Beam, Kevin M Elias, Fiona K Gibbons, Ali Salim, Kenneth B Christopher
INTRODUCTION: Little is known about long term survival risk factors in critically ill burn patients who survive hospitalization. We hypothesized that patients with major burns who survive hospitalization would have favorable long term outcomes. METHODS: We performed a two center observational cohort study in 365 critically ill adult burn patients who survived to hospital discharge. The exposure of interest was major burn defined a priori as >20% total body surface area burned [TBSA]...
June 9, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28592930/the-airway-in-inhalational-injury-diagnosis-and-management
#16
A Sabri, H Dabbous, A Dowli, R Barazi
It is estimated that 13.000 to 22.000 individuals suffer from inhalational burns each year in the United States alone. Despite these high numbers, inhalational burns remain a major challenge to otolaryngologists. In this paper, a review of literature is presented in order to provide otolaryngologists with a systematic approach to patients with inhalational burns to optimize treatment, cost, morbidity and, most importantly, mortality. For this purpose, a broad PubMed search was conducted. The available literature was found to highlight the importance of airway management in terms of the timing of intubation, method of intubation, trachea-esophageal (TE) fistula formation and TE rupture...
March 31, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28592928/comparison-of-six-outcome-prediction-models-in-an-adult-burn-population-in-a-developing-country
#17
S H Salehi, K As'adi, A Abbaszadeh-Kasbi, M S Isfeedvajani, N Khodaei
There are two types of prognostic model - burn-specific and general - to predict mortality risk in burn patients. Most prediction models were devised in developed countries. The aim of this study was to compare the performance of six outcome models in a developing country. In a retrospective cohort study, data of all thermal burned adult patients (age ≥ 18 years) admitted to the Burn Intensive Care Unit (BICU) were collected and then the following six prediction models were used to assess each patient: Acute Physiology and Chronic Health Evaluation (APACHE II), Abbreviated Burn Severity Index (ABSI), Belgian Outcome in Burn Injury (BOBI), the Ryan model, revised Baux and FLAMES model...
March 31, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28592162/natural-and-synthetic-products-used-for-the-treatment-of-smoke-inhalation-a-patent-review
#18
Fernanda Oliveira De Carvalho, Érika Ramos Silva, Fernanda Araújo Felipe, Luciana Garcez Barretto Teixeira, Luciana Beatriz Silva Zago, Paula Santos Nunes, Saravanan Shanmugam, Mairim Russo Serafini, Adriano Antunes de Souza Araújo
Inhalation injury is the leading cause of death in burn patients and is usually caused by the uninhibited absorption of smoke, which has an extremely toxic effect on the respiratory system. The physiopathology of inhalation injury covers multiple factors and the injured respiratory system may present deterioration in a few hours. Areas covered: In this present review, we analyzed patents based on both natural and synthetic products developed for the treatment of smoke inhalation. We found 14 patents in Espacenet, 25 in WIPO and none in the USPTO data search...
June 28, 2017: Expert Opinion on Therapeutic Patents
https://www.readbyqxmd.com/read/28589152/increased-mortality-in-women-sex-differences-in-burn-outcomes
#19
Karen Karimi, Iris Faraklas, Giavonni Lewis, Daniel Ha, Bridget Walker, Yan Zhai, Gareth Graves, Sharmila Dissanaike
BACKGROUND: There is increasing evidence that sex differences may influence responses after thermal injury and affect clinical outcomes. The objective of this study was to evaluate the relationships between sex, thermal injury, body size, and inpatient mortality in burn patients. METHODS: Medical records of adults with >20% total body surface area (TBSA) burn injury admitted to two American Burn Association (ABA)-verified burn centers between 2008 and 2014 were retrospectively reviewed...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28576239/inhalation-injury-pathophysiology-diagnosis-and-treatment
#20
REVIEW
Samuel W Jones, Felicia N Williams, Bruce A Cairns, Robert Cartotto
The classic determinants of mortality from severe burn injury are age, size of injury, delays of resuscitation, and the presence of inhalation injury. Of the major determinants of mortality, inhalation injury remains one of the most challenging injuries for burn care providers. Patients with inhalation injury are at increased risk for pneumonia (the leading cause of death) and multisystem organ failure. There is no consensus among leading burn care centers in the management of inhalation injury. This article outlines the current treatment algorithms and the evidence of their efficacy...
July 2017: Clinics in Plastic Surgery
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