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Burn resuscitation

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https://www.readbyqxmd.com/read/29140950/development-of-clinical-process-measures-for-pediatric-burn-care-understanding-variation-in-practice-patterns
#1
Lewis E Kazis, Robert L Sheridan, Gabriel D Shapiro, Austin F Lee, Matthew H Liang, Colleen M Ryan, Jeffrey C Schneider, Martha Lydon, Marina Soley-Bori, Lily A Sonis, Emily C Dore, Tina Palmieri, David Herndon, Walter Meyer, Petra Warner, Richard Kagan, Frederick J Stoddard, Michael Murphy, Ronald G Tompkins
BACKGROUND: There has been little systematic examination of variation in pediatric burn care clinical practices and its effect on outcomes. As a first step, current clinical care processes need to be operationally defined. The highly specialized burn care units of the Shriners Hospitals for Children system present an opportunity to describe the processes of care. The aim of this study was to develop a set of process-based measures for pediatric burn care and examine adherence to them by providers in a cohort of pediatric burn patients...
November 14, 2017: Journal of Trauma and Acute Care Surgery
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
#2
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
#3
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/29113868/a-case-of-influenza-type-a-myocarditis-that-presents-with-st-elevation-mi-cardiogenic-shock-acute-renal-failure-and-rhabdomyolysis-and-with-rapid-recovery-after-treatment-with-oseltamivir-and-intra-aortic-balloon-pump-support
#4
Eleni Geladari, Vasilios Papademetriou, Hans Moore, David Lu
We present a 59-year-old black male with history of type-1 diabetes and alcohol abuse. Patient became critically ill after a 5-day period of burning throat discomfort. On arrival patient was lethargic, in cardiogenic shock with a blood pressure of 81/47mmHg. Immediate diagnoses included diabetic ketoacidosis, acute renal failure, and possible septic shock. He was intubated, resuscitated with intravenous fluids, maintained on three inotropic agents, and given empiric wide spectrum antibiotics. An ECG showed a new ST elevation MI and an echocardiogram showed severe LV dysfunction...
May 2, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29068759/severe-burns-in-a-patient-after-out-of-hospital-cpr
#5
Nir Biterman, Arthur Kerner, Doron Aronson, Yaron BarLavie, Yehuda Ullmann, Michael Kapeliovich
We present a case of a patient after prolonged cardio-pulmonary resuscitation on hot asphalt, who suffered from first and second degree burns which worsened during hospitalization. The patient was treated with therapeutic hypothermia. Possible effect of therapeutic hypothermia on the course of burns is discussed.
October 25, 2017: Acute Cardiac Care
https://www.readbyqxmd.com/read/29052820/evaluation-of-different-treatment-protocols-for-combined-injury-induced-lung-injury-in-rabbits
#6
Xiao Bing Li
BACKGROUND: This study aims to evaluate the effectiveness of different treatment regimens on combined injury-induced lung injury. METHODS: Rabbits were subjected to non-lethal closed-chest bilateral lung contusion followed by a 30% total body surface area scald burn. The rabbits were randomly assigned to resuscitation groups that maintained a minimum mean arterial blood pressure of 70 mmHg using one of the following three methods: normal saline plus polygeline injection in a ratio of 1:1 (1:1G), normal saline plus polygeline injection in a ratio of 1:2 (1:2G), and normal saline plus polygeline injection in a ratio of 1:3 (1:3G), After injury, lung injury was assessed using lung wet-to-dry (W/D) weight ratio, enzyme-linked immunosorbent assay, and real-time PCR...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29024269/fluid-resuscitation-in-patients-with-severe-burns-a-meta-analysis-of-randomized-controlled-trials
#7
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/29023362/glycocalyx-shedding-is-enhanced-by-age-and-correlates-with-increased-fluid-requirement-in-patients-with-major-burns
#8
Akinori Osuka, Hirofumi Kusuki, Kazuhiro Yoneda, Hiroshi Matsuura, Hisatake Matsumoto, Hiroshi Ogura, Masashi Ueyama
BACKGROUND: Massive fluid shift following severe burn injury leads to edema and intravascular fluid loss that may result in burn-induced compartment syndrome (BICS) when corrected by aggressive fluid resuscitation. Factors causing this fluid shift remain unclear. Because glycocalyx regulates endothelial permeability, we hypothesized that glycocalyx shedding would increase fluid requirements in burn patients. This prospective cohort study aimed to identify relationships between shedding of the glycocalyx and fluid requirements following burn injury...
October 11, 2017: Shock
https://www.readbyqxmd.com/read/28982177/adipose-derived-stem-cells-attenuate-pulmonary-microvascular-hyperpermeability-after-smoke-inhalation
#9
Koji Ihara, Satoshi Fukuda, Baigalmaa Enkhtaivan, Raul Trujillo, Dannelys Perez-Bello, Christina Nelson, Anita Randolph, Suzan Alharbi, Hira Hanif, David Herndon, Donald Prough, Perenlei Enkhbaatar
BACKGROUND: Pulmonary edema is a hallmark of acute respiratory distress syndrome (ARDS). Smoke inhalation causes ARDS, thus significantly increasing the mortality of burn patients. Adipose-derived stem cells (ASCs) exert potent anti-inflammatory properties. The goal of the present study was to test the safety and ecfficacy of ASCs, in a well-characterized clinically relevant ovine model of ARDS. METHODS: Female sheep were surgically prepared. ARDS was induced by cooled cotton smoke inhalation...
2017: PloS One
https://www.readbyqxmd.com/read/28969436/acquired-methemoglobinemia-after-hydroxocobalamin-administration-in-a-patient-with-burns-and-inhalation-injury
#10
Alisha Z Jiwani, Vikhyat S Bebarta, Leopoldo C Cancio
CONTEXT: Hydroxocobalamin is an effective cyanide antidote. While erythema, hypertension, and chromaturia are recognized side effects, methemoglobinemia has not been reported. Methemoglobin levels are most accurately measured by co-oximetry. We describe an extensively burned patient who developed methemoglobinemia within an hour of hydroxocobalamin administration. CASE DETAILS: A 47-year old man without genetic deficiencies or abnormal hemoglobin variants presented with 61% body surface area thermal burns and grade 1 inhalation injury sustained during a tugboat engine explosion...
October 3, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28964882/the-effects-of-major-burn-related-pathophysiological-changes-on-the-pharmacokinetics-and-pharmacodynamics-of-drug-use-an-appraisal-utilizing-antibiotics
#11
Andrew A Udy, Jason A Roberts, Jeffrey Lipman, Stijn Blot
Patients suffering major burn injury represent a unique population of critically ill patients. Widespread skin and tissue damage causes release of systemic inflammatory mediators that promote endothelial leak, extravascular fluid shifts, and cardiovascular derangement. This phase is characterized by relative intra-vascular hypovolaemia and poor peripheral perfusion. Large volume intravenous fluid resuscitation is generally required. The patients' clinical course is then typically complicated by ongoing inflammation, protein catabolism, and marked haemodynamic perturbation...
September 28, 2017: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/28955423/variations-in-injury-characteristics-among-paediatric-patients-following-trauma-a-retrospective-descriptive-analysis-comparing-pre-hospital-and-in-hospital-deaths-at-kamuzu-central-hospital-lilongwe-malawi
#12
Laura Purcell, Charles E Mabedi, Jared Gallaher, Steven Mjuweni, Sean McLean, Bruce Cairns, Anthony Charles
BACKGROUND: Trauma is a major cause of paediatric mortality in sub-Saharan Africa. In absence of pre-hospital care, the injury mechanism and cause of death is difficult to characterise. Injury characteristics of pre-hospital deaths (PHD) versus in-hospital deaths (IHD) were compared. METHODS: Using our trauma surveillance database, a retrospective, descriptive analysis of children (<18 years) presenting to Kamuzu Central Hospital in Lilongwe, Malawi from 2008 to 2013 was performed...
June 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/28951113/update-on-metabolism-and-nutrition-therapy-in-critically-ill-burn-patients
#13
E Moreira, G Burghi, W Manzanares
Major burn injury triggers severe oxidative stress, a systemic inflammatory response, and a persistent hypermetabolic and hypercatabolic state with secondary sarcopenia, multiorgan dysfunction, sepsis and an increased mortality risk. Calorie deficit, negative protein balance and antioxidant micronutrient deficiency after thermal injury have been associated to poor clinical outcomes. In this context, personalized nutrition therapy with early enteral feeding from the start of resuscitation are indicated. Over the last four decades, different nutritional and pharmacological interventions aimed at modulating the immune and metabolic responses have been evaluated...
September 23, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28926876/-advances-in-the-research-of-characteristics-and-treatment-of-burns-in-the-elderly
#14
R Liu, Z Y Li
With the development of society and the improvement of medical level, the average life span of human has been increasing year by year. The proportion of elderly burn patients is also increasing yearly, which has become a social problem that can not be ignored. Because of physiological characteristics, such as decreased function of heart, lung, and kidney, degenerative changes of neural system, reduced gastrointestinal function and immunological function, and mostly accompanied by primary diseases of diabetes and cardiovascular diseases, elderly burn patients suffer from high shock rate and mortality, and their wounds are not easy to heal...
September 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28926874/-multicenter-epidemiological-investigation-of-hospitalized-elderly-young-and-middle-aged-patients-with-severe-burn
#15
Y Tang, L X Wang, W G Xie, Z A Shen, G H Guo, J J Chen, C M Han, L C Ren, Z G Chu, M F Yin, Y Wang, D X Zhang, Y S Huang, J P Zhang
Objective: To compare and analyze the epidemiological characteristics of hospitalized elderly, young and middle-aged patients with severe burn in recent years, so as to provide reference for the prevention and treatment of elderly patients with severe burn. Methods: Relying on the entry system of epidemiological case data and biological sample of severe burn from multicenter in clinic, medical records of patients with severe burn, aged above 18, hospitalized in 8 burn wards from January 2012 to December 2015 were collected...
September 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28879205/pediatric-burn-resuscitation-past-present-and-future
#16
REVIEW
Kathleen S Romanowski, Tina L Palmieri
Burn injury is a leading cause of unintentional death and injury in children, with the majority being minor (less than 10%). However, a significant number of children sustain burns greater than 15% total body surface area (TBSA), leading to the initiation of the systemic inflammatory response syndrome. These patients require IV fluid resuscitation to prevent burn shock and death. Prompt resuscitation is critical in pediatric patients due to their small circulating blood volumes. Delays in resuscitation can result in increased complications and increased mortality...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28802983/systemic-and-local-management-of-burn-wounds
#17
REVIEW
Alessio Vigani, Christine A Culler
Management of severe burn injury (SBI) requires prompt, complex, and aggressive care. Despite major advances in the management of SBI-including patient-targeted resuscitation, management of inhalation injuries, specific nutritional support, enhanced wound therapy, and infection control-the consequences of SBI often result in complex, multiorgan metabolic changes. Consensus guidelines and clinical evidence regarding specific management of small animal burn patients are lacking. This article aims to review updated therapeutic consideration for the systemic and local management of SBI that are proven effective to optimize outcomes in human burn patients and may translate to small animal patients...
November 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28801150/three-dimensional-wound-mapping-software-compared-to-expert-opinion-in-determining-wound-area
#18
E Farrar, O Pujji, S Jeffery
INTRODUCTION: New technologies in the field of burn wound and scar assessment are continually being evaluated. Accurate estimation of total body surface area (TBSA) burn wound is of paramount importance in fluid resuscitation to prevent complications which are associated with morbidity and mortality. Estimating the TBSA is performed by a multitude of different methods, however a gold standard would be ideal. The aim of this study was to compare the estimation of burned TBSA% between 3D photography by Panasonic FZ-M1 Toughpad in conjunction with WoundCare Lite software and expert opinion volunteered by burns doctors...
August 8, 2017: Burns: Journal of the International Society for Burn Injuries
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
#19
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/28795672/-effects-of-three-different-concentrations-of-hypertonic-sodium-salt-resuscitation-on-liver-injury-of-rats-at-the-early-stage-of-severe-burned
#20
Congsong Sun, Jiping Zhou, Chunyu Yuan, Yexiang Sun, Xulin Chen, Fei Wang, Qiang Wang
OBJECTIVE: To investigate the effects of three different concentrations of hypertonic sodium salt (HS) resuscitation on liver injury of rats at the early stage of severe burned. METHODS: 104 female Sprage-Dawley (SD) rats were randomly divided into five groups: sham group (n = 8), lactated Ringer solution (LR) group (n = 24), 600, 800, 1 000 mmol/L HS groups (HS600, HS800, and HS1000 groups, n = 24). Rats in LR group and HS groups were subjected to full-thickness scald with 30% total body surface area (TBSA), and then given liquid resuscitation treatment with LR and the corresponding HS...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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