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Burn fluid management

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https://www.readbyqxmd.com/read/29132247/management-of-a-rare-case-with-severe-hydrofluoric-acid-burns-important-roles-of-neutralizers-and-continuous-renal-replacement-therapy
#1
Yuanhai Zhang, Xingang Wang, Yuezhen Liu, Xinhua Jiang, Chunjiang Ye, Liangfang Ni, Liping Zhang, Jianfen Zhang, Bin Xu, Chunmao Han
Hydrofluoric acid (HF), a dangerous inorganic acid, is widely used in various industries and in daily life. Chemical burns caused by HF exposure occur more frequently in some regions worldwide. It has been reported that some cases with HF burns can be lethal due to the hypertoxicity of HF. In this article, we present a case of a 24-year-old worker who suffered HF burns by 53% HF solution to his face, neck, and nasal cavity. This patient quickly developed electrolyte disturbance, that is, hypocalcemia, and hypopotassemia, and myocardial injury after exposure...
November 1, 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/29119060/intra-abdominal-hypertension-in-severe-burns-prevalence-incidence-and-mortality-in-a-sub-saharan-african-hospital
#2
Ronald Mbiine, Rose Alenyo, Olive Kobusingye, Job Kuteesa, Cephas Nakanwagi, Hervé Monka Lekuya, Olivia Kituuka, Moses Galukande
BACKGROUND: Severe burns have been shown to be a risk factor for developing intra-abdominal hypertension (IAH). Fluid resuscitation practices used in burns management further predispose patients to intra-abdominal hypertension. The mortality associated with IAH in severe burns is estimated to be more than 74.5% once organ dysfunction occurs. Despite 95% of all burns occurring in Low and Middle income countries (LMIC), there is paucity of published data on this topic in sub-Saharan Africa...
2017: International Journal of Burns and Trauma
https://www.readbyqxmd.com/read/29102099/white-lipped-tree-viper-cryptelytrops-albolabris-envenomation-in-an-american-viper-keeper
#3
Spencer Greene, Laura Ann Galdamez, Richard Tomasheski
BACKGROUND: Snakebites are common in many regions of the United States. Bites from exotic species, however, are rare. The white-lipped tree viper, Cryptelytrops (formerly Trimeresurus) albolabris, is a pit viper native to Southeast Asia. Bites are common in countries such as Myanmar, India, Thailand, Indonesia, and China. In this report, we describe an envenomation in an American viper keeper. CASE REPORT: A healthy 28-year-old right-handed man who collects venomous snakes experienced a bite to the distal left thumb from a neonatal C...
October 25, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29024269/fluid-resuscitation-in-patients-with-severe-burns-a-meta-analysis-of-randomized-controlled-trials
#4
Yuan Kao, El-Wui Loh, Chien-Chin Hsu, Hung-Jung Lin, Chien-Cheng Huang, Yun-Yun Chou, Chieh-Chun Lien, Ka-Wai Tam
OBJECTIVES: Fluid resuscitation is the mainstay treatment to reconstitute intravascular volume and maintain end-organ perfusion in patients with severe burns. The use of a hyper-osmotic or iso-osmotic solution in fluid resuscitation to manage myocardial depression and increased capillary permeability during burn shock has been debated. We conducted a systematic review and meta-analysis to compare the efficacies of hyper-osmotic and iso-osmotic solutions in restoring hemodynamic stability after burn injuries...
October 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29021723/bacterial-infections-in-burn-wound-patients-at-a-tertiary-teaching-hospital-in-accra-ghana
#5
O A Forson, E Ayanka, M Olu-Taiwo, P J Pappoe-Ashong, P J Ayeh-Kumi
Intact human skin surface is essential for protection against infection, preservation of body fluid homeostasis and thermoregulation. Burn injury compromises the skin barrier and enables bacterial infection, hence delaying burn wound healing. This study aimed to determine the microbial profile of burn wounds, and resistance patterns of microbes with respect to the source of the injured patient's wound. Fifty wound swab samples were collected from fifty burn patients at the Korle-Bu Teaching Hospital, Accra (KBTH)...
June 30, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28916849/1000-consecutive-cases-of-laser-assisted-liposuction-utilizing-the-1440%C3%A2-nm-wavelength-nd-yag-laser-assessing-the-safety-and-efficacy
#6
Christopher T Chia, Mark G Albert, Sharon Del Vecchio, Spero J Theodorou
BACKGROUND: Liposuction remains one of the most popular aesthetic surgery procedures performed today, and it has undergone continuous refinements over the past four decades. Advancements in anesthesia, improvements in instrumentation, better understanding of fluid dynamics and the addition of energy to liposuction have led to better outcomes with improved safety and efficacy. OBJECTIVES: The purpose of this study is to review 1000 consecutive laser-assisted liposuction (LAL) cases utilizing the 1440 nm wavelength...
September 15, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28877133/tear-dysfunction-syndrome-after-burn
#7
Jeong Won Seo, Hyun Sun Jeon, Jae Ryong Han
The objective of this study was to evaluate tear dysfunction of burn patients objectively. We retrospectively reviewed medical records of patients who had been examined within 1 week after burn injury. Visual acuity, intraocular pressure, cilia burned state, tear film break-up time (TBUT), and fluorescein corneal staining were evaluated. Sixty-four eyes of 32 patients (man 27, female 5) were included. Mean age was 44.41 ± 12.76 years old. Mean best corrected visual acuity was logMAR 0.04 ± 0.08, mean intraocular pressure was 13...
August 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28797577/comparison-of-two-dimensional-methods-versus-three-dimensional-scanning-systems-in-the-assessment-of-total-body-surface-area-estimation-in-burn-patients
#8
Helene Retrouvey, Justin Chan, Shahriar Shahrokhi
BACKGROUND: Accurate measurement of percent total body surface area (%TBSA) burn is crucial in the management of burn patients for calculating the estimated fluid resuscitation, determining the need to transfer to a specialized burn unit and probability of mortality. %TBSA can be estimated using many methods, all of which are relatively inaccurate. Three-dimensional (3D) systems have been developed to improve %TBSA calculation and consequently optimize clinical decision-making. The objective of this study was to compare the accuracy of percent total burn surface area calculation by conventional methods against novel 3D methods...
August 7, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28649575/ecmo-in-major-burn-patients-feasibility-and-considerations-when-multiple-modes-of-mechanical-ventilation-fail
#9
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/28602591/skin-grafts-from-genetically-modified-%C3%AE-1-3-galactosyltransferase-knockout-miniature-swine-a-functional-equivalent-to-allografts
#10
D A Leonard, C Mallard, A Albritton, R Torabi, M Mastroianni, D H Sachs, J M Kurtz, C L Cetrulo
Burn is associated with a considerable burden of morbidity worldwide. Early excision of burned tissue and skin grafting of the resultant wound has been established as a mainstay of modern burn therapy. However, in large burns, donor sites for autologous skin may be limited. Numerous alternatives, from cadaver skin to synthetic substitutes have been described, each with varying benefits and limitations. We previously proposed the use of genetically modified (alpha-1,3-galactosyl transferase knockout, GalT-KO) porcine skin as a viable skin alternative...
June 8, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28601484/resuscitation-using-less-fluid-has-no-negative-impact-on-hydration-status-in-children-with-moderate-sized-scalds-a-prospective-single-centre-uk-study
#11
Linda Hollén, Karen Coy, Andrew Day, Amber Young
BACKGROUND: After a burn, optimal fluid resuscitation is critical for positive patient outcome. Although national guidelines advocate using resuscitation fluids of 4mL per kg body weight and percent body surface area (%BSA) for paediatric burns of >10% BSA, evidence in adults suggest that such volumes lead to over-resuscitation and related complications. Our aim was to investigate whether children managed with biosynthetic dressings (Biobrane™) and reduced fluid volumes remain well hydrated, as determined by clinical and laboratory parameters...
November 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28601203/the-care-of-thermally-injured-patients-in-operational-austere-and-mass-casualty-situations
#12
REVIEW
Booker T King, Wylan C Peterson
Burn injury affects a half million people in the United States annually. The severe thermal injury can have long-term debilitating effects. The management of burn patients in austere and operational environments is more complex. Mass casualty incidents can result in a large number of patients with multiple traumatic injuries, which often include burn injury. Appropriate triage of casualties is essential. Severely burned patients should be evacuated to a burn center if possible. Airway management and fluid resuscitation of burn patients present unique challenges...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28576249/pediatric-burn-care-unique-considerations-in-management
#13
REVIEW
Amita R Shah, Lillian F Liao
Severe pediatric burns require a multidisciplinary team approach at a specialized pediatric burn center. Special attention must be paid to estimations of total body surface area, fluid resuscitation and metabolic demands, and adequate analgesia and sedation. Long-term effects involve scar management and psychosocial support to the child and their family. Compassionate comprehensive burn care is accomplished by a multidisciplinary team offering healing in the acute setting and preparing the child and family for long-term treatment and care...
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28576244/clinician-s-guide-to-nutritional-therapy-following-major-burn-injury
#14
REVIEW
Christina Rollins, Franziska Huettner, Michael W Neumeister
This article provides a clinician's guide to nutritional support of the burn patient. The authors review the assessment and management of the needs of the thermally injured patient and provide recommendations on replacement and supplementation with calories, protein, carbohydrates, lipids, fluids, and minerals. Furthermore, the authors compare and contrast enteral versus parenteral delivery of nutrition.
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28576238/acute-fluid-management-of-large-burns-pathophysiology-monitoring-and-resuscitation
#15
REVIEW
Justin Gillenwater, Warren Garner
This article reviews the pathophysiology of large burn injury and the extreme fluid shifts that occur in the hours and days after this event. The authors focus on acute fluid management, monitoring of hemodynamic status, and end points of resuscitation. Understanding the need and causes for fluid resuscitation after burn injury helps the clinician develop an effective plan to balance the competing goals of normalized tissue perfusion and limited tissue edema. Thoughtful, individualized treatment is the best answer and the most effective compromise...
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28570315/assessment-of-outreach-by-a-regional-burn-center-could-referral-criteria-revision-help-with-utilization-of-resources
#16
Nicholas H Carter, Clint Leonard, Lisa Rae
The objective of this study was to identify trends in preburn center care, assess needs for outreach and education efforts, and evaluate resource utilization with regard to referral criteria. The authors hypothesized that many transferred patients were discharged home after brief hospitalizations and without need for operation. Retrospective chart review of all adult and pediatric transfers to our regional burn center from July 2012 to July 2014. Details of initial management including TBSA estimation, fluid resuscitation, and intubation status were recorded...
May 19, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28530774/a-rare-type-of-burn-injury-due-to-butane-gas-inhalation
#17
Ergin Seven, Uğur Horoz, Elif Sarı, Hülda Rifat Özakpınar, Mert Muhittin Sandıkcı, Emre İnözü, Ali Teoman Tellioğlu
BACKGROUND: Abusive inhalation of butane gas is becoming a serious public health problem among teenagers and young adult population; however, there has been little reporting on explosion burns associated with abuse of butane cigarette lighter fluid. METHODS: Retrospective study was conducted of 22 patients who were burned in last 2 years in explosion of butane gas, a flammable, odorless, and colorless aliphatic hydrocarbon. RESULTS: Details of sociodemographic profile of the patients, any underlying psychiatric illness, alcohol abuse, depth of burn injury, any associated injury, duration of hospitalization, and percentage of burned area were recorded and analyzed...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28526303/the-use-of-biobrane-%C3%A2-for-wound-coverage-in-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis
#18
Alan D Rogers, Erin Blackport, Robert Cartotto
INTRODUCTION: Published experience describing the use of Biobrane(®) for wound management in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis (SJS-TEN) is limited to case reports and case series involving ten or fewer patients. We have used Biobrane(®) in the care of SJS-TEN since 2000, and the purpose of this study was to review our experience with the application of Biobrane(®) for wound coverage in SJS-TEN. METHODS: A retrospective review of all cases of SJS-TEN admitted to an adult regional ABA-verified burn center between January 1, 2000 and June 1, 2015 was conducted...
November 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28520803/multiple-modality-biomarker-prediction-of-cognitive-impairment-in-prospectively-followed-de-novo-parkinson-disease
#19
Chelsea Caspell-Garcia, Tanya Simuni, Duygu Tosun-Turgut, I-Wei Wu, Yu Zhang, Mike Nalls, Andrew Singleton, Leslie A Shaw, Ju-Hee Kang, John Q Trojanowski, Andrew Siderowf, Christopher Coffey, Shirley Lasch, Dag Aarsland, David Burn, Lana M Chahine, Alberto J Espay, Eric D Foster, Keith A Hawkins, Irene Litvan, Irene Richard, Daniel Weintraub
OBJECTIVES: To assess the neurobiological substrate of initial cognitive decline in Parkinson's disease (PD) to inform patient management, clinical trial design, and development of treatments. METHODS: We longitudinally assessed, up to 3 years, 423 newly diagnosed patients with idiopathic PD, untreated at baseline, from 33 international movement disorder centers. Study outcomes were four determinations of cognitive impairment or decline, and biomarker predictors were baseline dopamine transporter (DAT) single photon emission computed tomography (SPECT) scan, structural magnetic resonance imaging (MRI; volume and thickness), diffusion tensor imaging (mean diffusivity and fractional anisotropy), cerebrospinal fluid (CSF; amyloid beta [Aβ], tau and alpha synuclein), and 11 single nucleotide polymorphisms (SNPs) previously associated with PD cognition...
2017: PloS One
https://www.readbyqxmd.com/read/28452888/the-impact-of-patient-weight-on-burn-resuscitation
#20
Nehemiah T Liu, Craig A Fenrich, Maria L Serio-Melvin, Wylan C Peterson, Leopoldo C Cancio, José Salinas
BACKGROUND: Optimal fluid resuscitation of burn patients with burns greater than 20% total body surface area is critical to prevent burn shock during the initial 24 hours to 48 hours postburn. Currently, most resuscitation formulas incorporate the patient's weight when estimating 24-hour fluid requirements. The objective of this study was to determine the impact of weight on fluid resuscitation requirements and outcomes during the initial 24 hours after admission. METHODS: We performed a retrospective review of patients admitted to our burn intensive care unit from December 2007 to April 2013, resuscitated with a computerized decision support system...
July 2017: Journal of Trauma and Acute Care Surgery
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