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Burn resuscitation

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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
#1
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
#2
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/28600109/the-cardio-respiratory-effects-of-intra-abdominal-hypertension-considerations-for-critical-care-nursing-practice
#3
REVIEW
Martin Christensen, Judy Craft
Intra-abdominal hypertension can be classified as either primary or secondary. Primary intra-abdominal hypertension is often associated through trauma or diseases of the abdominopelvic region such as pancreatitis or abdominal surgery, while secondary intra-abdominal hypertension is the result of extra-abdominal causes such as sepsis or burns. The critically ill patient offers some challenges in monitoring in particular secondaryintra-abdominal hypertension because of the effects of fluid resuscitation, the use of inotropes and positive pressure ventilation...
June 6, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28592938/thermal-burn-in-a-30-minute-old-newborn-report-on-the-youngest-patient-with-iatrogenic-burn-injury
#4
L Abboud, G Ghanimeh
Burns in infants are rare. The majority of neonatal burns occur in the hospital setting. The immaturity of their immune system, their fragile and thin skin, difficulties in resuscitation, engraftment paucity limited by donor sites, and long-term complications make taking care of burned newborns extremely difficult. We present the case of a newborn burned 30 minutes after his birth over a total body surface of 35%, when the hot water bottle used in the hospital accidentally burst. This is the earliest iatrogenic burn in a newborn reported to date...
March 31, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28586577/pattern-and-profile-of-electric-burn-injury-cases-at-a-burn-centre
#5
Saeed Ashraf Cheema
BACKGROUND: Electrical burns are quite different from thermal and chemical burns. This study is from a centre which deals with job related electric burn injuries alone and thus can give a pure account of the electric burns and discuss the related peculiarities. Study aims to highlight the differences in the mechanism of electric burn injury, its mode of presentation, morbidity, complications and thus the treatment strategies as compared to rest of the burn injuries. METHODS: This is a descriptive case series study of first consecutive 61 electric burn victims treated at a Burn Unit and Plastic Surgery centre...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28576250/patient-safety-in-burn-care-application-of-evidence-based-medicine-to-improve-outcomes
#6
REVIEW
Elizabeth L Dale, Charles Scott Hultman
This article reviews 5 areas in burn care that increasingly use evidence-based medicine to optimize quality and safety: resuscitation protocols, transfusion practices, vascular access, venous thromboembolic prophylaxis, and rational use of antibiotics.
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28576249/pediatric-burn-care-unique-considerations-in-management
#7
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/28576239/inhalation-injury-pathophysiology-diagnosis-and-treatment
#8
REVIEW
Samuel W Jones, Felicia N Williams, Bruce A Cairns, Robert Cartotto
The classic determinants of mortality from severe burn injury are age, size of injury, delays of resuscitation, and the presence of inhalation injury. Of the major determinants of mortality, inhalation injury remains one of the most challenging injuries for burn care providers. Patients with inhalation injury are at increased risk for pneumonia (the leading cause of death) and multisystem organ failure. There is no consensus among leading burn care centers in the management of inhalation injury. This article outlines the current treatment algorithms and the evidence of their efficacy...
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28576238/acute-fluid-management-of-large-burns-pathophysiology-monitoring-and-resuscitation
#9
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/28576236/burn-care-in-low-and-middle-income-countries
#10
REVIEW
Anthony G Charles, Jared Gallaher, Bruce A Cairns
This article examines the societal impact of thermal injury in low- and middle-income countries. The authors describe the unique challenges of these health care systems in providing care for burned patients, focusing on resuscitation, excision and grafting, rehabilitation, and reconstruction.
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28573147/the-progress-of-chinese-burn-medicine-from-the-third-military-medical-university-in-memory-of-its-pioneer-professor-li-ao
#11
REVIEW
Haisheng Li, Junyi Zhou, Yizhi Peng, Jiaping Zhang, Xi Peng, Qizhi Luo, Zhiqiang Yuan, Hong Yan, Daizhi Peng, Weifeng He, Fengjun Wang, Guangping Liang, Yuesheng Huang, Jun Wu, Gaoxing Luo
Professor Li Ao was one of the founders of Chinese burn medicine and one of the most renowned doctors and researchers of burns in China. He established one of the Chinese earliest special departments for burns at Third Military Medical University (TMMU) in 1958. To memorialize Professor Li Ao on his 100th birthday in 2017 and introduce our extensive experience, it is our honor to briefly review the development and achievement of the Chinese burn medicine from TMMU. The epidemiology and outcomes of admitted burn patients since 1958 were reviewed...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28570316/severity-of-inhalation-injury-is-predictive-of-alterations-in-gas-exchange-and-worsened-clinical-outcomes
#12
Tia Sutton, Ian Lenk, Peggie Conrad, Marcia Halerz, Michael Mosier
Inhalation injury (INH) is present in one third of large burn injuries and increases oxygenation and fluid resuscitation requirements, incidences of pulmonary complications, risk for multiple organ dysfunction syndrome (MODS), and overall mortality. Previous studies have demonstrated inconsistent correlation between bronchoscopic evaluation and clinical outcomes. The authors reviewed 161 patients admitted with a diagnosis of INH or underwent diagnostic bronchoscopy for suspected INH over a period of 8.5 years...
May 12, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28570315/assessment-of-outreach-by-a-regional-burn-center-could-referral-criteria-revision-help-with-utilization-of-resources
#13
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/28570309/admission-rapid-thrombelastography-rteg%C3%A2-values-predict-resuscitation-volumes-and-patient-outcomes-after-thermal-injury
#14
Todd F Huzar, Eric Martinez, Joseph Love, Tonya C George, Jaimin Shah, Lisa Baer, James M Cross, Charles E Wade, Bryan A Cotton
In trauma, admission rapid thrombelastography (rTEG) has been shown to predict in-hospital thromboembolic events, guide treatment of coagulopathy, and identify likely to require large volume resuscitations. We sought to evaluate the use of rTEG in describing the coagulation status of major burn patients at admission and assess whether rTEG values predicted resuscitation volumes and patient outcomes. This is a retrospective study of all patients admitted to our Burn ICU between January 2010 and December 2012...
May 26, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28522168/is-pre-hospital-cpr-a-risk-factor-for-early-death-in-patients-transferred-to-an-adult-burn-center
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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 Mayr, 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)...
June 2017: Lancet Haematology
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