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Burn resuscitation

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https://www.readbyqxmd.com/read/29757442/effect-of-intravenous-fluid-volumes-on-the-adrenal-glucocorticoid-response-after-burn-injury-in-swine
#1
Belinda I Gómez, Celestine He, Tony Chao, Michael A Dubick, David M Burmeister
Objective: Severe thermal injury induces metabolic and physiological stress, prompting a disruption in the hypothalamic-pituitary-adrenal axis. The objective of this study was to evaluate potential confounding effects of Lactated Ringer's (LR) resuscitation on adrenal damage and cortisol production following burn. Methods: Anesthetized swine were instrumented with jugular catheters and sustained 40% TBSA burns from brass probes heated to 100ºC. Animals recovered to consciousness and received IV fluid resuscitation with LR at two different volumes: 15 mL/kg/day (Limited Volume; LV, n=6) or 2 mL/kg/%TBSA/day (Modified Brooke; MB, n=6)...
May 11, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29753454/response-of-a-local-hospital-to-a-burn-disaster-contributory-factors-leading-to-zero-mortality-outcomes
#2
Eng-Kean Yeong, Ciaran P O'Boyle, Hui-Fu Huang, Hao-Chih Tai, Yen-Chun Hsu, Shu-Yang Chuang, Yu-Feng Wu, Che-Wei Chang, Tom J Liu, Hong-Shiee Lai
OBJECTIVE: To investigate the outcomes of a local healthcare system in managing a burn mass casualty incident (BMCI). METHODS: Thirty-three victims admitted to the National Taiwan University Hospital within 96h of the explosion were included in the study. Data were recorded on: patient demographics, Baux score, laboratory data, management response, treatment strategies, and outcomes. Case notes from June 27, 2015 to November 2015 were reviewed with a focus on fluid resuscitation, ventilation support, nutrition, infection control, sepsis treatment, and wound closure plan...
May 9, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29721511/vitamin-d-status-and-its-influence-on-outcomes-following-major-burn-injury-and-critical-illness
#3
REVIEW
Khaled Al-Tarrah, Martin Hewison, Naiem Moiemen, Janet M Lord
Vitamin D deficiency is common among the general population. It is also observed in up to 76% of critically ill patients. Despite the high prevalence of hypovitaminosis D in critical illness, vitamin D is often overlooked by medical staff as the clinical implications and consequences of vitamin D deficiency in acute contexts remain to be fully understood. Vitamin D has a broad range of pleotropic effects on various processes and systems including the immune-inflammatory response. 1α,25-dihydroxyvitamin D (1,25(OH)2 D), has been shown to promote a tolerogenic immune response limiting deleterious inflammatory effects, modulation of the innate immune system, and enhancement of anti-microbial peptides...
2018: Burns and trauma
https://www.readbyqxmd.com/read/29719851/an-unforeseeable-complication-posterior-ischemic-optic-neuropathy-after-penetrating-injury-to-the-heart
#4
Joseph J Eid, Brian C Cronin, Susan Seman
Trauma surgeons are currently encountering unusual adverse events after traumatic injuries. Ischemic optic neuropathy is a rare complication that may occur in trauma and burn patients that present in extremis and require massive resuscitation. A 29-year-old male patient sustains a penetrating injury to the heart that required primary repair. He remained hemodynamically stable and required a limited amount of resuscitative fluids and products. Postoperatively, the patient develops acute painless bilateral loss of vision...
April 2018: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29718928/enteral-resuscitation-with-oral-rehydration-solution-to-reduce-acute-kidney-injury-in-burn-victims-evidence-from-a-porcine-model
#5
Belinda I Gómez, Matthew K McIntyre, Jennifer M Gurney, Kevin K Chung, Leopoldo C Cancio, Michael A Dubick, David M Burmeister
Intravenous (IV) resuscitation of burn patients has greatly improved outcomes and become a cornerstone of modern burn care. However, the heavy fluids and vascular access required may not be feasible in austere environments, mass casualty, or delayed transport scenarios. Enteral resuscitation has been proposed for these situations; we sought to examine the effectiveness of this strategy on improving burn-induced kidney injury. Anesthetized Yorkshire swine sustaining 40% TBSA full-thickness contact burns were randomized to three groups (n = 6/group): fluid deprivation, ad libitum water access, or 70 mL/kg/d Oral Rehydration Salt solution (ORS)...
2018: PloS One
https://www.readbyqxmd.com/read/29690735/-lay-emphasis-on-circulatory-state-research-after-fluid-resuscitation-in-early-burns
#6
Q Zhang, Y Q Tang
In this article, we discuss future development of circulatory state research after fluid resuscitation in early burns from its history and difficulties confronted. We believe that the Chinese fluid resuscitation formula to predict initial volume of fluid infusion of extensive burn patients is still useful and effective, while we should attach more importance to advances in the research of burn pathophysiology, basic theory and clinical practices of Chinese fluid resuscitation formula, so as to provide strategy of fluid resuscitation in early burns for international burn world...
April 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/29651952/special-traumatized-populations-burns-and-hypothermia
#7
Shruti Mehrotra, Amita Misir
It is important for physicians treating children to be aware of unique presentation that require expertise and knowledge. Two areas of importance when caring for traumatized children are Thermal Burn Injuries, and Hypothermia. Burns commonly result in morbidity in children; as such, the appropriate identification of the severity of the burn and appropriate management are integral to minimize the complications of burns during the acute phase. Attention to proper fluid management is paramount. Knowledge of types of solutions to use during Burn treatment is important...
April 11, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29622333/emergency-care-of-pediatric-burns
#8
REVIEW
Ashley M Strobel, Ryan Fey
Although the overall incidence of and mortality rate associated with burn injury have decreased in recent decades, burns remain a significant source of morbidity and mortality in children. Children with major burns require emergent resuscitation. Resuscitation is similar to that for adults, including pain control, airway management, and administration of intravenous fluid. However, in pediatrics, fluid resuscitation is needed for burns greater than or equal to 15% of total body surface area (TBSA) compared with burns greater than or equal to 20% TBSA for adults...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29615134/improving-outcomes-after-pediatric-cardiac-arrest-the-icu-resuscitation-project-study-protocol-for-a-randomized-controlled-trial
#9
Ron W Reeder, Alan Girling, Heather Wolfe, Richard Holubkov, Robert A Berg, Maryam Y Naim, Kathleen L Meert, Bradley Tilford, Joseph A Carcillo, Melinda Hamilton, Matthew Bochkoris, Mark Hall, Tensing Maa, Andrew R Yates, Anil Sapru, Robert Kelly, Myke Federman, J Michael Dean, Patrick S McQuillen, Deborah Franzon, Murray M Pollack, Ashley Siems, John Diddle, David L Wessel, Peter M Mourani, Carleen Zebuhr, Robert Bishop, Stuart Friess, Candice Burns, Shirley Viteri, David A Hehir, R Whitney Coleman, Tammara L Jenkins, Daniel A Notterman, Robert F Tamburro, Robert M Sutton
BACKGROUND: Quality of cardiopulmonary resuscitation (CPR) is associated with survival, but recommended guidelines are often not met, and less than half the children with an in-hospital arrest will survive to discharge. A single-center before-and-after study demonstrated that outcomes may be improved with a novel training program in which all pediatric intensive care unit staff are encouraged to participate in frequent CPR refresher training and regular, structured resuscitation debriefings focused on patient-centric physiology...
April 3, 2018: Trials
https://www.readbyqxmd.com/read/29605724/timing-of-laparotomy-and-closure-in-burn-patients-with-abdominal-compartment-syndrome-effects-on-survival
#10
Jesus I Ramirez, Soman Sen, Tina L Palmieri, David G Greenhalgh
BACKGROUND: Survival of burned patients with abdominal compartment syndrome (ACS) is uniformly reported to be poor, averaging just 16% after laparotomy. We hypothesize that better outcomes may be achieved with a strategy of immediate laparotomy and early fascial closure. STUDY DESIGN: Patients with burn injury who were diagnosed with ACS between 2005 and 2016 were identified through a search of databases. Data was gathered from electronic medical records. Timing of laparotomy and closure were calculated for each patient...
March 29, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29605028/pyruvate-as-a-novel-carrier-of-hydroxyethyl-starch-130-0-4-may-protect-kidney-in-rats-subjected-to-severe-burns
#11
Sen Hu, Yue-Long Dai, Ming-Juan Gao, Xiao-Na Wang, Hai-Bin Wang, Yong-Qi Dou, Xiao-Dong Bai, Fang-Qiang Zhou
BACKGROUND: The carrier of hydroxyethyl starch (HES) may play a critical role in kidney injury in fluid resuscitation. This study aimed mainly to compare effects of pyruvate-enriched saline with normal saline (NS) and acetate Ringer's (AR) solution as a carrier in HES130/0.4 on kidney function in rats subjected to severe burns. METHODS: Using a lethal burn model, 140 rats were randomly allocated in seven groups (n = 20): sham group (group S); no fluid after burn (group N); burn resuscitated with NS (group NS); burn resuscitated with pyruvate saline (group PS); burn resuscitated with AR plus pyruvate-HES (group SP); burn resuscitated with AR plus acetate-HES (group SA), and burn resuscitated with AR plus NS-HES (group SN)...
May 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29596291/interprofessional-simulations-promote-knowledge-retention-and-enhance-perceptions-of-teamwork-skills-in-a-surgical-trauma-burn-intensive-care-unit-setting
#12
Katie L George, Beth Quatrara
BACKGROUND: The current state of health care encompasses highly acute, complex patients, managed with ever-changing technology. The ability to function proficiently in critical care relies on knowledge, technical skills, and interprofessional teamwork. Integration of these factors can improve patient outcomes. Simulation provides "hands-on" practice and allows for the integration of teamwork into knowledge/skill training. However, simulation can require a significant investment of time, effort, and financial resources...
May 2018: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/29554046/the-evolution-of-pediatric-transfusion-practice-during-combat-operations-2001-2013
#13
Jeremy W Cannon, Lucas P Neff, Heather F Pidcoke, James K Aden, Philip C Spinella, Michael A Johnson, Andrew P Cap, Matthew A Borgman
BACKGROUND: Hemostatic resuscitation principles have significantly changed adult trauma resuscitation over the past decade. Practice patterns in pediatric resuscitation likely have changed as well; however, this evolution has not been quantified. We evaluated pediatric resuscitation practices over time within a combat trauma system. METHODS: The Department of Defense Trauma Registry (DoDTR) was queried from 2001-2013 for pediatric patients (<18 years). Patients with burns, drowning, and missing injury severity score (ISS) were excluded...
March 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29538774/a-review-of-the-first-seminar-that-set-the-stage-for-the-creation-of-the-american-burn-association
#14
Michael J Feldman
As the first civilian burn center in the United States, the Evans-Haynes burn center shares a rich history with the American Burn Association. This is evidenced by a review of Dr. B.W. Haynes Jr's personal notes, which were shared with us by his daughter. Dr. Haynes states, in his own hand writing, that this 1959 burn seminar led to the formation of the American Burn Association. The manuscript contains a meticulous collection of discussions among leaders in the development of modern burn care. These discussions range from debates about burn resuscitation and the early use of antibiotics to the reconstruction of large burn defects and release of burn scars...
February 20, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29530306/contemporary-burn-survival
#15
Karel D Capek, Linda E Sousse, Gabriel Hundeshagen, Charles D Voigt, Oscar E Suman, Celeste C Finnerty, Kristofer Jennings, David N Herndon
BACKGROUND: The standard of burn treatment today reflects major advances. We sought to quantitate the impact of these advances on burn survival via age-stratified mortality ratios compared with other reported mortality analyses in burns. STUDY DESIGN: Age, percent of the total body surface area (TBSA) burned, presence of inhalation injury, length of stay, and survival status were recorded at admission and at discharge for all new burn admissions between 1989 and 2017...
April 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29519275/-effect-of-different-concentrations-of-hypertonic-sodium-fluid-resuscitation-on-intestine-injury-in-rats-at-the-early-stage-of-severe-burn
#16
Yexiang Sun, Chunyu Yuan, Xulin Chen, Fei Wang, Congsong Sun, Zhi Gao, Sheng Liu
OBJECTIVE: To investigate the effect of different concentrations of hypertonic saline solution (HS) on intestine injury in rats at the early stage of severe burn. METHODS: 104 adult healthy female Sprague-Dawley (SD) rats were randomly divided into five groups: sham group (n = 8), lactated Ringer solution (LR) group (n = 24) and 200, 300, 400 mmol/L HS group (HS200 group, HS300 group, HS400 group, all n = 24). All the rats in LR group and different concentrations of HS groups were scalded for 30% total body surface area (TBSA) with III degree, after immediately, the rats were given burn resuscitation therapy by LR or corresponding concentrations of HS through the tail vein...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29497619/the-validation-study-on-a-three-dimensional-burn-estimation-smart-phone-application-accurate-free-and-fast
#17
A K W Cheah, T Kangkorn, E H Tan, M L Loo, S J Chong
Background: Accurate total body surface area burned (TBSAB) estimation is a crucial aspect of early burn management. It helps guide resuscitation and is essential in the calculation of fluid requirements. Conventional methods of estimation can often lead to large discrepancies in burn percentage estimation. We aim to compare a new method of TBSAB estimation using a three-dimensional smart-phone application named 3D Burn Resuscitation (3D Burn) against conventional methods of estimation-Rule of Palm, Rule of Nines and the Lund and Browder chart...
2018: Burns and Trauma
https://www.readbyqxmd.com/read/29461290/volume-resuscitation-in-patients-with-high-voltage-electrical-injuries
#18
Derek M Culnan, Kelley Farner, Genevieve H Bitz, Karel D Capek, Yiji Tu, Carlos Jimenez, William C Lineaweaver
Volume resuscitation of patients with high-voltage electrical injuries (>1000 V) is a more complex challenge than standard burn resuscitation. High voltages penetrate deep tissues. These deep injuries are not accounted for in resuscitation formulae dependent on percentage of cutaneous burn. Myonecrosis occurring from direct electrical injury and secondary compartment syndromes can result in rhabdomyolysis, compromising renal function and urine output. Urine output is the primary end point, with a goal of 1 mL/kg/h for adult patients with high-voltage electrical injuries...
March 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29395761/cyanide-poisoning-is-a-possible-cause-of-cardiac-arrest-among-fire-victims-and-empiric-antidote-treatment-may-improve-outcomes
#19
Yasuhiko Kaita, Takehiko Tarui, Takahiro Shoji, Hiroshi Miyauchi, Yoshihiro Yamaguchi
BACKGROUND: Carbon monoxide and cyanide poisoning are important causes of death due to fire. Carbon monoxide is more regularly assessed than cyanide at the site of burn or smoke inhalation treatment due to its ease in assessment and simplicity to treat. Although several forensic studies have demonstrated the significance of cyanide poisoning in fire victims using blood cyanide levels, the association between the cause of cardiac arrest and the concentration of cyanide among fire victims has not been sufficiently investigated...
May 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29395403/the-value-of-whatsapp-communication-in-paediatric-burn-care
#20
R Martinez, A D Rogers, A Numanoglu, H Rode
BACKGROUND: Telemedicine is increasingly applied in developed settings to facilitate transfer of information to and from burn surgeons across vast geographic areas. WhatsApp is a widely available and extremely user-friendly encrypted smartphone application that does not require the expensive physical and personnel infrastructure that characterizes many of these telemedicine systems. The aim of this study was to review the use of WhatsApp to facilitate paediatric burn injury consultations to a regional burn centre in a developing country, where burn care continues to be thwarted by administrative apathy, poor resource allocation and lack of attention to medical and nursing education at all levels...
January 27, 2018: Burns: Journal of the International Society for Burn Injuries
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