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Burn resuscitation

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https://www.readbyqxmd.com/read/28522168/is-pre-hospital-cpr-a-risk-factor-for-early-death-in-patients-transferred-to-an-adult-burn-center
#1
Kanika Trehan, Stacey Rotta, Shea C Gregg, Kristen Glasgow, Roselle E Crombie, Walter M Cholewczynski, Nabil Atweh, Alisa Savetamal
BACKGROUND: Burn patients who require cardiopulmonary resuscitation (CPR) prior to admission to a Burn Center are anecdotally known to suffer higher mortality than those who do not require pre-hospital CPR. STUDY DESIGN: A retrospective chart review identified adult patients admitted to our burn center between 2013 and 2015. Included patients met one or both of the following criteria: (1) 20 percent or more total body surface area (%TBSA) burned and (2) need for intubation prior to admission to our facility...
May 15, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28486305/a-27-year-follow-up-for-a-patient-with-100-total-body-surface-area-burn
#2
Pan Wu, Xingang Wang, Ronghua Jin, Jon Kee Ho, Liping Zhang, Yueliang Ding, Chunmao Han
Patients suffering from severe 100% TBSA burns are particularly vulnerable to infection and multiple organ dysfunction syndrome, being on high risks of poor outcomes. Treatment of these patients remains to be a great challenge for burn physicians, and survivors of 100% TBSA burns generally have poor quality of life after burn. Since, to our knowledge, this is the first case report on the long-term follow-up of a 100% TBSA burn survivor, the authors are presenting the initial injury, treatment, and follow-up of this female patient during 27 years...
May 8, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28481839/high-ratio-plasma-resuscitation-does-not-improve-survival-in-pediatric-trauma-patients
#3
Jeremy W Cannon, Michael A Johnson, Robert C Caskey, Matthew A Borgman, Lucas P Neff
BACKGROUND: Damage control resuscitation (DCR) including balanced resuscitation with high ratios of plasma (PLAS) and platelets (PLT) to packed red blood cells (PRBC) improves survival in adult patients. We sought to evaluate the effect of a high ratio PLAS to PRBC resuscitation strategy in massively transfused pediatric patients with combat injuries. METHODS: The Department of Defense Trauma Registry (DoDTR) was queried from 2001-2013 for pediatric trauma patients (<18 years)...
May 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28467581/can-we-make-an-early-do-not-resuscitate-decision-in-severe-burn-patients
#4
Yücel Yüce, Hakan Ahmet Acar, Kutlu Hakan Erkal, Erhan Tuncay
BACKGROUND: The present study was conducted to examine topic of issuing early do-not-resuscitate (DNR) order at first diagnosis of patients with severe burn injuries in light of current law in Turkey and the medical literature. DNR requires withholding cardiopulmonary resuscitation in event of respiratory or cardiac arrest and allowing natural death to occur. It is frequently enacted for terminal cancer patients and elderly patients with irreversible neurological disorders. METHODS: Between January 2009 and December 2014, 29 patients (3...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28459413/-advance-on-human-umbilical-cord-mesenchymal-stem-cells-for-treatment-of-ali-in-severe-burns
#5
Yu Wang, Xiaohong Hu
Severe burn is often accompanied by multiple organ damage. Acute lung injury (ALI) is one of the most common complications, and often occurs in the early stage of severe burns. If it is not treated in time, it will progress to acute respiratory distress syndrome (ARDS), which will be a serious threat to the lives of patients. At present, the treatment of ALI in patients with severe burn is still remained in some common ways, such as the liquid resuscitation, the primary wound treatment, ventilation support, and anti-infection...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28457980/reversal-of-trauma-induced-coagulopathy-using-first-line-coagulation-factor-concentrates-or-fresh-frozen-plasma-retic-a-single-centre-parallel-group-open-label-randomised-trial
#6
Petra Innerhofer, Dietmar Fries, Markus Mittermayr, Nicole Innerhofer, Daniel von Langen, Tobias Hell, Gottfried Gruber, Stefan Schmid, Barbara Friesenecker, Ingo H Lorenz, Mathias Ströhle, Verena Rastner, Susanne Trübsbach, Helmut Raab, Benedikt Treml, Dieter Wally, Benjamin Treichl, Agnes Mayer, Christof Kranewitter, Elgar Oswald
BACKGROUND: Effective treatment of trauma-induced coagulopathy is important; however, the optimal therapy is still not known. We aimed to compare the efficacy of first-line therapy using fresh frozen plasma (FFP) or coagulation factor concentrates (CFC) for the reversal of trauma-induced coagulopathy, the arising transfusion requirements, and consequently the development of multiple organ failure. METHODS: This single-centre, parallel-group, open-label, randomised trial was done at the Level 1 Trauma Center in Innsbruck Medical University Hospital (Innsbruck, Austria)...
April 27, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28452888/the-impact-of-patient-weight-on-burn-resuscitation
#7
Nehemiah T Liu, Craig A Fenrich, Maria L Serio-Melvin, Wylan C Peterson, Leopoldo C Cancio, José Salinas
INTRODUCTION: Optimal fluid resuscitation of burn patients with burns greater than 20% total body surface area (TBSA) is critical to prevent burn shock during the initial 24 to 48 hours post burn. 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...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28447933/acute-decompensated-heart-failure-new-strategies-for-improving-outcomes
#8
Emily Singer Fisher, Boyd Burns
Acute decompensated heart failure is a common emergency department presentation with significant associated morbidity and mortality. Heart failure accounts for more than 1 million hospitalizations annually, with a steadily increasing incidence as our population ages. This issue reviews recent literature regarding appropriate management of emergency department presentations of acute decompensated heart failure, with special attention to newer medication options. Emergency department management and appropriate interventions are discussed, along with critical decision-making points in resuscitation for both hypertensive and hypotensive patients...
May 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28427138/-advances-in-the-research-of-treatment-of-burns-in-the-elderly
#9
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/28394880/the-variation-of-hemodynamic-parameters-through-picco-in-the-early-stage-after-severe-burns
#10
Chen Gong, Fang Zhang, Lei Li, Fang He, Gong-Cheng Liu, Shi-Hui Zhu, Guang-Yi Wang, Zhao-Fan Xia
To investigate early hemodynamics of severely burned patients via PiCCO and to discuss clinical significance of hemodynamic monitoring for burn shock resuscitation, 55 extensive burn patients were enrolled in this retrospective study. The fluid resuscitation was guided according to Chinese General Formula and adjusted with urinary output of 0.5-1.0 ml/h/kg as a resuscitation goal. All patients were diagnosed within a relatively stable condition during burn shock stage, and they received PiCCO monitoring within 6 hours after burn...
April 3, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28363300/microsurgical-reconstruction-of-the-burned-hand-and-upper-extremity
#11
REVIEW
Mauricio De la Garza, Michael Sauerbier, Germann Günter, Curtis L Cetrulo, Reuben A Bueno, Robert C Russell, Michael W Neumeister
Improvements in critical care and burn victim resuscitation have led to increased survival of burned patients. Initial resuscitation, early excision of burned tissues, prevention of burn wound sepsis, and wound coverage remain mainstays of care. Many burn wounds require complex reconstruction. This is particularly important in the hand. Coverage of tendons, ligaments, joints, vessels, nerves, and bones of the hand requires healthy vascularized tissue to maintain viability and function. Local flaps or regional flaps may be within the burn zone of injury...
May 2017: Hand Clinics
https://www.readbyqxmd.com/read/28363290/acute-management-of-hand-burns
#12
REVIEW
Ashwin Soni, Tam N Pham, Jason H Ko
The hand is extremely susceptible to burn injuries, and hand burns can occur in up to 90% of all major burns. A thorough neurovascular examination of the hand should be performed in the acute setting. Escharotomies are required in patients with full-thickness or circumferential burns, when perfusion of the upper extremity is compromised. The decision for excision and grafting is based on whether the wound will heal in the first 2 to 3 weeks after the burn injury. Acute care and resuscitation are always importance in this patient population; subsequent care leads to optimal hand functionality and cosmetic long-term outcomes...
May 2017: Hand Clinics
https://www.readbyqxmd.com/read/28328669/burn-state-of-the-science-fluid-resuscitation
#13
Robert Cartotto, David G Greenhalgh, C Cancio
Recognition of fluid creep has driven a large amount of the scientific investigation in the area of acute fluid resuscitation for burn patients. The role of colloids in ameliorating fluid creep is controversial, despite the fact that a fluid-sparing effect of colloids has been recognized for some time. All but one of the available prospective studies using colloids are more than a decade old, and a modern randomized controlled trial (RCT) comparing crystalloids to colloids is long overdue. While urinary output continues to be the main endpoint for fluid titration, there has been a moderate amount of interest in the use of transpulmonary thermodilution to guide fluid resuscitation...
May 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28328660/addressing-the-barriers-to-bioimpedance-spectroscopy-use-in-major-burns-alternate-electrode-placement
#14
Pippa Kenworthy, Tiffany L Grisbrook, Michael Phillips, William Gibson, Fiona M Wood, Dale W Edgar
Bioimpedance spectroscopy (BIS) is a method used to assess body composition and fluid distribution. As a technology for measurement of fluid shifts during acute burn resuscitation, there are potential barriers to its use due to the location of wounds. This study aimed to determine whether alternate electrode positions were a suitable alternative compared to standardized (manufacturer) positions in moderate to large size burns for the measurement of BIS resistance and fluid changes. BIS measurements were collected in standard and alternate electrode placements and in an open wound and Acticoat™ dressing condition...
March 15, 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
#15
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/28149246/acute-kidney-injury-in-critically-burned-patients-resuscitated-with-a-protocol-that-includes-low-doses-of-hydroxyethyl-starch
#16
M Sánchez-Sánchez, A Garcia-de-Lorenzo, L Cachafeiro, E Herrero, M J Asensio, A Agrifoglio, E Flores, B Estebanez, P Extremera, C Iglesias, J R Martinez
Acute kidney injury (AKI) is an important complication in burn patients. Recently, it has been recommended that hydroxyethyl starch (HES) be avoided in burn patients because it increases the incidence of AKI. Our purpose was to study incidence of AKI in critically ill burn patients resuscitated with Ringer's solution and supplements of HES. We conducted an observational study of 165 patients admitted to the critical care burn unit (with 30 ± 15% TBSA burned). The main outcome measures were incidence of AKI, contributions of colloids and crystalloids, various severity scores, comorbidities, complications and mortality...
September 30, 2016: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28079548/history-and-advancement-of-burn-treatments
#17
Hai-Fei Liu, Feng Zhang, William C Lineaweaver
Advances in burn care have accelerated within the last 50 years. The principal modalities of and approaches to burn treatment include dressings, antimicrobials, fluid resuscitation, burn wound excision, skin grafting, and use of skin substitutes. This review presents a historical outline of these approaches, their current status, and prospects for the future of burn care.
February 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28070608/xuebijing-injection-treatment-inhibits-vasopermeability-and-reduces-fluid-requirements-in-a-canine-burn-model
#18
F-B Tang, Y-L Dai, S Hu, L-Q Ma, J-Y Li, H-P Zhang, W-H Zhang, Y-G Li, H-B Wang, H-Y Lin, Q Hu, L Li
OBJECTIVE: High vasopermeability and excessive inflammation following severe burns may result in tissue edema, organ dysfunction and the loss of circulatory plasma volume, which can influence the doctor to do the prognosis to the patients. The study aims to examine whether Xuebijing injection (XBJ), an extracts of a traditional Chinese medicine used to treat sepsis in clinic, can reduces fluid requirements by inhibiting vasopermeability and tissue edema in a canine model after burn injury...
January 9, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28045780/cardiovascular-responsiveness-to-vasopressin-and-%C3%AE-1-adrenergic-receptor-agonists-after-burn-injury
#19
Ann E Evans, P Geoff Vana, Heather M LaPorte, Richard H Kennedy, Richard L Gamelli, Matthias Majetschak
The effects of burn injury on cardiovascular responsiveness to vasoactive agents are not well understood. The aims of this study were to determine whether burn injury alters cardiovascular reactivity to vasoactive drugs in vivo and intrinsic function of isolated mesenteric resistance arteries. Anesthetized Sprague-Dawley rats were subjected to sham procedure or 30% TBSA dorsal scald burn, followed by crystalloid resuscitation (Parkland Formula). At 24, 72, 96, and 168 hours post burn, rats were reanesthetized, and the mean arterial blood pressure (MAP) responses to various doses of the α1-adrenergic receptor agonist phenylephrine and arginine vasopressin were tested...
March 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28043267/-investigation-of-emergency-capacities-for-occupational-hazard-accidents-in-silicon-solar-cell-producing-enterprises
#20
D D Yang, J N Xu, B L Zhu
Objective: To investigate and analyze the influential factors of occupational hazard acci-dents, emergency facilities and emergency management in Silicon solar cell producing enterprises, then to pro-vide scientific strategies. Methods: The methods of occupationally healthy field investigating, inspecting of ven-tilation effectiveness, setup of emergency program and wearing chemical suit were used. Results: The mainly occupational hazard accidents factors in the process of Silicon solar cell producing included poisoning chemi-cals, high temperature, onizing radiation and some workplaces...
November 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
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