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Burn fluid management

Benjamin Ziegler, Christoph Hirche, Johannes Horter, Jurij Kiefer, Paul Alfred Grützner, Thomas Kremer, Ulrich Kneser, Matthias Münzberg
INTRODUCTION: Initial therapy of severe burns in specialized burn trauma centers is a challenging task faced by the treating multi-professional and interdisciplinary team. A lack of consistent operating procedures and varying structural conditions was recently demonstrated in preliminary data of our group. These results raised the question on how specific treatment measures in acute burn care are met in the absence of standardized guidelines. MATERIAL AND METHODS: A specific questionnaire containing 57 multiple-choice questions was sent to all 22 major burn centers in Germany, Austria and Switzerland...
September 21, 2016: Burns: Journal of the International Society for Burn Injuries
Chih-Chun Chang, Chin-Chuan Yeh, Fang-Yeh Chu
The Formosa Fun Coast explosion, occurring in a recreational water park located in the Northern Taiwan on 27 June 2015, made 499 people burn-injured. For those who had severe burn trauma, surgical intervention and fluid resuscitation were necessary, and potential blood transfusion therapy could be initiated, especially during and after broad escharotomy. Here, we reviewed the literature regarding transfusion medicine and skin grafting as well as described the practicing experience of combined tissue and blood bank in the burn disaster in Taiwan...
October 2016: Transfusion and Apheresis Science
Arunpandian Balaji, Saravana Kumar Jaganathan, Ahmad Fauzi Ismail, Rathanasamy Rajasekar
Management of burn injury is an onerous clinical task since it requires continuous monitoring and extensive usage of specialized facilities. Despite rapid improvizations and investments in burn management, >30% of victims hospitalized each year face severe morbidity and mortality. Excessive loss of body fluids, accumulation of exudate, and the development of septic shock are reported to be the main reasons for morbidity in burn victims. To assist burn wound management, a novel polyurethane (PU)-based bio-nanofibrous dressing loaded with honey (HN) and Carica papaya (PA) fruit extract was fabricated using a one-step electrospinning technique...
2016: International Journal of Nanomedicine
Atilla Şenaylı, Fatma Öztürk, Müjdem Nur Azılı, Sabri Demir, Rabia Demir, Emrah Şenel
BACKGROUND: Burns constitute one of the most important, potentially fatal types of trauma. Appropriate emergency management is essential in the avoidance of complication and the success of treatment. Emergency management and indications of transfer throughout the country were reviewed in the present study. METHODS: Charts of 187 patients transferred to the present hospital from other cities between January 2009 and December 2013 were evaluated. Factors included demographics, referral vehicles, intravenous fluid therapy, respiratory conditions, urine drainage, and surgical complications...
May 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Shou-Cheng Teng
According to previous research, adjunctive negative pressure wound therapy (NPWT) can help manage infected wounds when applied along with appropriate debridement and antibiotic therapy as deemed clinically relevant. NPWT not only removes fluid, and reduces oedema, but also promotes perfusion around the wounds. In addition, NPWT may lead to improved graft fixation when used as a bolster, especially in patients who are less compliant or have poor graft fixation that result from using traditional methods. NPWT is a good choice to bolster skin grafts in young, active and less-compliant patients...
September 2016: International Wound Journal
M C Plancq, L Goffinet, V Duquennoy-Martinot
Burn is still a frequent accident in children and particularly occurs in young children under 4years. The majority were caused by hot liquids (scalds) with mixed-dermal burns and is commonly treated conservatively with surgery performed at 10-15 days post-injury after healing of superficial burn. Patients with burns greater than 10% need early fluid resuscitation and adequate nutritional support to avoid deepening with infection, improve healing and survival. Hypovolemic shock could be very abrupt in children...
October 2016: Annales de Chirurgie Plastique et Esthétique
P Guilabert, G Usúa, N Martín, L Abarca, J P Barret, M J Colomina
Since 1968, when Baxter and Shires developed the Parkland formula, little progress has been made in the field of fluid therapy for burn resuscitation, despite advances in haemodynamic monitoring, establishment of the 'goal-directed therapy' concept, and the development of new colloid and crystalloid solutions. Burn patients receive a larger amount of fluids in the first hours than any other trauma patients. Initial resuscitation is based on crystalloids because of the increased capillary permeability occurring during the first 24 h...
September 2016: British Journal of Anaesthesia
S Cutts, R Talboys, C Paspula, E M Prempeh, R Fanous, D Ail
Adult respiratory distress syndrome (ARDS) has now been described as a sequela to such diverse conditions as burns, amniotic fluid embolism, acute pancreatitis, trauma, sepsis and damage as a result of elective surgery in general. Patients with ARDS require immediate intubation, with the average patient now being ventilated for between 8 and 11 days. While the acute management of ARDS is conducted by the critical care team, almost any surgical patient can be affected by the condition and we believe that it is important that a broader spectrum of hospital doctors gain an understanding of the nature of the pathology and its current treatment...
August 11, 2016: Annals of the Royal College of Surgeons of England
Nehemiah T Liu, José Salinas, Craig A Fenrich, Maria L Serio-Melvin, George C Kramer, Ian R Driscoll, Martin A Schreiber, Leopoldo C Cancio, Kevin K Chung
INTRODUCTION: The depth of burn has been an important factor often overlooked when estimating the total resuscitation fluid needed for early burn care. The goal of this study was to determine the degree to which full thickness (FT) involvement impacted overall 24-hour burn resuscitation volumes. METHODS: We performed a retrospective review of patients admitted to our burn intensive care unit from December 2007 to April 2013, with significant burns who required resuscitation using our computerized decision support system for burn fluid resuscitation...
July 6, 2016: Journal of Trauma and Acute Care Surgery
Wei Sun, Dinghong Min, Guanghua Guo
Toxic epidermal necrolysis (TEN) is a potentially life-threatening condition usually attributed to severe adverse drug reactions. The evolvement of TEN, including extensive epidermal sloughing, fluid and electrolyte imbalances, hypermetabolism, immune dysfunction, sepsis and organs failure, are very similar to that of extensive burn. There is no unified therapeutic regimen for TEN due to its unclear pathogenesis.This article reviews the recent progress in regard to TEN in etiology, pathogenesis, diagnosis, differential diagnosis, treatment, new standard diagnostic approach, primary care, and supportive treatment...
June 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Saif Yousif, Mark Walsh, Hannah Burns
INTRODUCTION: Bilateral vocal cord palsy is a condition which has many causes (Gupta et al., 2012) [1]. Syringomyelia is an uncommon condition which describes the formation of fluid filled cavity, occupying the spinal cord (Chang, 2003) [2]. It rarely manifests itself as subacute onset of stridor. PRESENTATION OF CASE: We present the case of a three year old female who presented for evaluation of her speech and language delay, when incidentally it was made note of her loud breathing which had previously been managed as bronchiolitis by her general practitioner...
2016: International Journal of Surgery Case Reports
Alethea Tan, Sarah Smailes, Thessa Friebel, Ashish Magdum, Quentin Frew, Naguib El-Muttardi, Peter Dziewulski
Burn survival has improved with advancements in fluid resuscitation, surgical wound management, wound dressings, access to antibiotics and nutritional support for burn patients. Despite these advancements, the presence of smoke inhalation injury in addition to a cutaneous burn still significantly increases morbidity and mortality. The pathophysiology of smoke inhalation has been well studied in animal models. Translation of this knowledge into effectiveness of clinical management and correlation with patient outcomes including the paediatric population, is still limited...
August 2016: Burns: Journal of the International Society for Burn Injuries
D M El Sakka
The tissue expansion technique is part of the reconstructive surgeon's armamentarium. It provides donor skin that is an optimal match in terms of skin colour, texture, sensation and hair-bearing characteristics. Tissue expansion of the scalp is one of the methods used for the management of alopecia. This method allows the expansion of normal hair-bearing scalp to cover the area of alopecia. Unfortunately, the tough galeal layer prevents easy and fast expansion of the scalp and increases the rate of expander extrusion...
September 30, 2015: Annals of Burns and Fire Disasters
Robert M T Staruch, A Beverly, D Lewis, Y Wilson, N Martin
AIMS: While the epidemiology of amputations in patients with burns has been investigated previously, the effect of an amputation on burn size and its impact on fluid management have not been considered in the literature. Fluid resuscitation volumes are based on the percentage of the total body surface area (%TBSA) burned calculated during the primary survey. There is currently no consensus as to whether the fluid volumes should be recalculated after an amputation to compensate for the new body surface area...
June 8, 2016: Journal of the Royal Army Medical Corps
Brad Shrum, Brian Church, Eric McArthur, Karen E A Burns, Tammy Znajda, Vivian McAlister
BACKGROUND: Fluid excess may place people undergoing surgery at risk for various complications. Hypertonic salt solution (HS) maintains intravascular volume with less intravenous fluid than isotonic salt (IS) solutions, but may increase serum sodium. This review was published in 2010 and updated in 2016. OBJECTIVES: To determine the benefits and harms of HS versus IS solutions administered for fluid resuscitation to people undergoing surgery. SEARCH METHODS: In this updated review we have searched the Cochrane Central Register of Controlled Trials (CENTRAL; Issue 4, 2016); MEDLINE (January 1966 to April 2016); EMBASE (January 1980 to April 2016); LILACS (January 1982 to April 2016) and CINAHL (January 1982 to April 2016) without language restrictions...
2016: Cochrane Database of Systematic Reviews
Alice Henschke, Richard Lee, Anthony Delaney
BACKGROUND: The objective of this study was to assess the quality of readily available evidence regarding critical care aspects of the management of patients with severe burn injuries. METHOD: PUBMED, EMBASE, Cochrane Databases and bibliographies of included studies and burns review articles were searched from inception of databases to end of February 2015. We included systematic reviews, randomised controlled trials (RCTs) and cohort studies with concurrent controls on the topics of (a) fluid resuscitation (b) analgesia (c) haemodynamic monitoring and targets (d) ventilation (e) blood transfusion...
September 2016: Burns: Journal of the International Society for Burn Injuries
Randy D Kearns, Kathe M Conlon, Annette F Matherly, Kevin K Chung, Vikhyat S Bebarta, Jacob J Hansen, Leopoldo C Cancio, Michael Peck, Tina L Palmieri
No abstract text is available yet for this article.
September 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
Eva Madrid, Gerard Urrútia, Marta Roqué i Figuls, Hector Pardo-Hernandez, Juan Manuel Campos, Pilar Paniagua, Luz Maestre, Pablo Alonso-Coello
BACKGROUND: Inadvertent perioperative hypothermia is a phenomenon that can occur as a result of the suppression of the central mechanisms of temperature regulation due to anaesthesia, and of prolonged exposure of large surfaces of skin to cold temperatures in operating rooms. Inadvertent perioperative hypothermia has been associated with clinical complications such as surgical site infection and wound-healing delay, increased bleeding or cardiovascular events. One of the most frequently used techniques to prevent inadvertent perioperative hypothermia is active body surface warming systems (ABSW), which generate heat mechanically (heating of air, water or gels) that is transferred to the patient via skin contact...
2016: Cochrane Database of Systematic Reviews
G H Guo
In recent years, growth in number of mass burn casualties accompanied by large number of deaths, has increased, such as dust blast occurred in Kunshan in 2014 and explosion of chemicals occurred in Tianjin in 2015. These disasters made us aware that our knowledge of care of mass burn casualties must be renewed, and therapeutic strategies currently practiced in ICU should be adopted. This paper introduces the concept of critical burn and provides reference on how to carry out fluid resuscitation, early enteral nutrition, mechanical ventilation, continuous renal replacement therapy, wound management, as well as infection control, etc...
March 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Ramzi Hassouneh, Rania Nasrallah, Joe Zimpelmann, Alex Gutsol, David Eckert, Jamie Ghossein, Kevin D Burns, Richard L Hébert
AIMS/HYPOTHESIS: The first clinical manifestation of diabetes is polyuria. The prostaglandin E2 (PGE2) receptor EP3 antagonises arginine vasopressin (AVP)-mediated water reabsorption and its expression is increased in the diabetic kidney. The purpose of this work was to study the contribution of EP3 to diabetic polyuria and renal injury. METHODS: Male Ep 3 (-/-) (also known as Ptger3 (-/-)) mice were treated with streptozotocin (STZ) to generate a mouse model of diabetes and renal function was evaluated after 12 weeks...
June 2016: Diabetologia
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