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Burn fluid management

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https://www.readbyqxmd.com/read/28649575/ecmo-in-major-burn-patients-feasibility-and-considerations-when-multiple-modes-of-mechanical-ventilation-fail
#1
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
#2
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
#3
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...
June 7, 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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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...
May 16, 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
#11
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
#12
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
https://www.readbyqxmd.com/read/28427138/-advances-in-the-research-of-treatment-of-burns-in-the-elderly
#13
Z Y Jiang, D H Min, G H Guo
With our country going into the aging society, burns in the elderly often occur. Studies have shown that the number of elderly burn patients has reached 13% to 20% of the total number of burn patients. As the sensory and cognitive functions are low, skin is thinning, the functions of heart, lung, and kidney are reduced, the immunity is impaired, and other physiological characteristics exist in the elderly, the wounds of elderly burn patients often heal slowly, and the mortality is high. At present, there is still a lack of enough attention to the elderly burn patients...
April 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28282004/five-year-retrospective-review-of-blunt-renal-injuries-at-a-level-i-trauma-center
#14
COMPARATIVE STUDY
Jessica Burns, Megan Brown, Zakaria I Assi, Eric J Ferguson
We report the experience of a Level I trauma center in the management of blunt renal injury during a 5-year period, with special attention to those treated using angiography with embolization. The institutional trauma registry was queried for all patients with blunt renal injury between September 1, 2009 and August 30, 2014. Each injury was graded using the American Association for the Surgery of Trauma guidelines. Patients that underwent angiography with embolization were reviewed for case-specific information including imaging findings, treatment, materials used, clinical course, and mortality...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28228201/five-year-retrospective-review-of-blunt-renal-injuries-at-a-level-i-trauma-center
#15
Jessica Burns, Megan Brown, Zakaria I Assi, Eric J Ferguson
We report the experience of a Level I trauma center in the management of blunt renal injury during a 5-year period, with special attention to those treated using angiography with embolization. The institutional trauma registry was queried for all patients with blunt renal injury between September 1, 2009 and August 30, 2014. Each injury was graded using the American Association for the Surgery of Trauma guidelines. Patients that underwent angiography with embolization were reviewed for case-specific information including imaging findings, treatment, materials used, clinical course, and mortality...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28212132/hydrocarbon-enema-an-unusual-cause-of-chemical-burn
#16
Justin Mygatt, Mustafa Amani, Patrick Ng, Brian Benson, Jeremy Pamplin, Leopoldo Cancio
Hydrocarbons are a wide-ranging group of flammable chemicals and are often used in suicide attempts either by ingestion or as accelerant in self-immolation. In this case study, we present a 37-year-old female who suffered 6% TBSA partial-thickness burns to her perineum and buttocks, which she claims resulted from diarrhea after ingesting a bottle of lighter fluid. The patient underwent decontamination and medical treatment for her burns and during her inpatient stay, it became apparent that the burns were more likely sustained from an intentional rectal administration of lighter fluid...
February 13, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28209192/learning-from-2523-trauma-deaths-in-india-opportunities-to-prevent-in-hospital-deaths
#17
Nobhojit Roy, Deepa Kizhakke Veetil, Monty Uttam Khajanchi, Vineet Kumar, Harris Solomon, Jyoti Kamble, Debojit Basak, Göran Tomson, Johan von Schreeb
BACKGROUND: A systematic analysis of trauma deaths is a step towards trauma quality improvement in Indian hospitals. This study estimates the magnitude of preventable trauma deaths in five Indian hospitals, and uses a peer-review process to identify opportunities for improvement (OFI) in trauma care delivery. METHODS: All trauma deaths that occurred within 30 days of hospitalization in five urban university hospitals in India were retrospectively abstracted for demography, mechanism of injury, transfer status, injury description by clinical, investigation and operative findings...
February 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28027250/important-developments-in-burn-care
#18
REVIEW
Kevin J Zuo, Abelardo Medina, Edward E Tredget
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Explain the epidemiology of severe burn injury in the context of socioeconomic status, gender, age, and burn cause. 2. Describe challenges with burn depth evaluation and novel methods of adjunctive assessment. 3. Summarize the survival and functional outcomes of severe burn injury. 4. State strategies of fluid resuscitation, endpoints to guide fluid titration, and sequelae of overresuscitation. 5. Recognize preventative measures of sepsis...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27931647/hemodynamic-coherence-in-patients-with-burns
#19
REVIEW
Sabri Soussi, Matthieu Legrand
Burn shock is characterized by profound hemodynamic alterations mainly associated with rapid loss of intravascular volume related to severe capillary leak. Thus, fluid resuscitation conventionally based on macrocirculatory targets is considered as a corner stone of initial management of patients with burns. Nonetheless, traditional markers such as blood pressure, urinary output, and cardiac output are helpful but do not sufficiently reflect the adequacy of perfusion and oxygenation at the microcirculatory level...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27846837/prevalence-aetiology-treatment-and-outcomes-of-shock-in-children-admitted-to-kenyan-hospitals
#20
George Mbevi, Philip Ayieko, Grace Irimu, Samuel Akech, Mike English
BACKGROUND: Shock may complicate several acute childhood illnesses in hospitals within low-income countries and has a high case fatality. Hypovolemic shock secondary to diarrhoea/dehydration and septic shock are thought to be common, but there are few reliable data on prevalence or treatment that differ for the two major forms of shock. Examining prevalence and treatment practices has become important since reports suggest high risks from liberal use of fluid boluses in African children...
November 16, 2016: BMC Medicine
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