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Burn resuscitation

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https://www.readbyqxmd.com/read/28427138/-advances-in-the-research-of-treatment-of-burns-in-the-elderly
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28029475/trali-following-fresh-frozen-plasma-resuscitation-from-burn-shock
#13
Larry M Jones, Nicholas Deluga, Puneet Bhatti, Scott R Scrape, John K Bailey, Rebecca A Coffey
INTRODUCTION: Resuscitation from burn shock using fresh frozen plasma (FFP) has been described. Critics of FFP resuscitation cite the development of transfusion related acute lung injury (TRALI) as a deterrent to its use. This study examines the occurrence of TRALI with FFP resuscitation of critically ill burned patients. METHODS: A retrospective chart review was conducted of severely burned patients who received FFP resuscitation. Data points included age, TBSA, TBSA full thickness, presence of alternate etiologies of acute lung injury, total FFP administered, and signs and symptoms of TRALI as defined per the Canadian Blood Services Consensus Conference...
March 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28027250/important-developments-in-burn-care
#14
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/28009701/burn-shock-and-resuscitation-proceedings-of-a-symposium-conducted-at-the-meeting-of-the-american-burn-association-chicago-il-21-april-2015
#15
Maria L Serio-Melvin, José Salinas, Kevin K Chung, Clayton Collins, John C Graybill, David T Harrington, David N Herndon, David G Greenhalgh, George C Kramer, Alicia Lintner, Michael J Mosier, Ashish Nagpal, Leopoldo C Cancio
The Special Interest Groups of the American Burn Association provide a forum for interested members of the multidisciplinary burn team to congregate and discuss matters of mutual interest. At the 47th Annual Meeting of the American Burn Association in Chicago, IL, the Fluid Resuscitation Special Interest Group sponsored a special symposium on burn resuscitation. The purpose of the symposium was to review the history, current status, and future direction of fluid resuscitation of patients with burn shock. The reader will note several themes running through the following presentations...
January 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28005932/the-use-of-procalcitonin-pct-for-diagnosis-of-sepsis-in-burn-patients-a-meta-analysis
#16
Luís Cabral, Vera Afreixo, Luís Almeida, José Artur Paiva
The continuous development of resuscitation techniques and intensive care reduced the mortality rate induced by the initial shock in burn patients and, currently, infections (especially sepsis) are the main causes of mortality of these patients. The misuse of antimicrobial agents is strongly related to antimicrobial and adverse patient outcomes, development of microbial resistance and increased healthcare-related costs. To overcome these risks, antimicrobial stewardship is mandatory and biomarkers are useful to avoid unnecessary medical prescription, to monitor antimicrobial therapy and to support the decision of its stop...
2016: PloS One
https://www.readbyqxmd.com/read/27986281/extracorporeal-cardiopulmonary-resuscitation-for-refractory-cardiac-arrest-a-multicentre-experience
#17
Mark Dennis, Peter McCanny, Mario D'Souza, Paul Forrest, Brian Burns, David A Lowe, David Gattas, Sean Scott, Paul Bannon, Emily Granger, Roger Pye, Richard Totaro
AIM: To describe the ECPR experience of two Australian ECMO centres, with regards to survival and neurological outcome, their predictors and complications. METHODS: Retrospective observational study of prospectively collected data on all patients who underwent extracorporeal cardiopulmonary resuscitation (ECPR) at two academic ECMO referral centres in Sydney, Australia. MEASUREMENTS AND MAIN RESULTS: Thirty-seven patients underwent ECPR, 25 (68%) were for in-hospital cardiac arrests...
March 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27931647/hemodynamic-coherence-in-patients-with-burns
#18
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/27920829/clinical-and-genetic-features-of-australian-families-with-long-qt-syndrome-a-registry-based-study
#19
Charlotte Burns, Jodie Ingles, Andrew M Davis, Vanessa Connell, Belinda Gray, Lauren Hunt, Julie McGaughran, Christopher Semsarian
BACKGROUND: Familial long QT syndrome (LQTS) is a primary arrhythmogenic disorder caused by mutations in ion channel genes. The phenotype ranges from asymptomatic individuals to sudden cardiac arrest and death. LQTS is a rare but significant health problem for which global data should exist. This study sought to provide the first clinical and genetic description of Australian families with LQTS. METHODS: We performed a cross-sectional study to evaluate clinical and genetic features of families with LQTS...
December 2016: Journal of Arrhythmia
https://www.readbyqxmd.com/read/27894390/-effects-of-different-fluid-resuscitation-program-on-renal-function-in-swine-during-shock-stage-of-severe-burn
#20
G L Su, W X Huang, J Chen, D J Xue, J J Zhou
Objective: To explore the effects of different fluid resuscitation program on renal function in swine during shock stage of severe burn. Methods: Twenty-four Guangxi Bama miniature swine were inflicted with 40% total body surface area on the back, and then they were divided into four groups according to the random number table, with 6 swine in each group. At post injury hour (PIH) 2, swine in succinylated gelatin group (S), hydroxyethyl starch group (H), and allogeneic plasma group (A) were respectively resuscitated with succinylated gelatin, hydroxyethyl starch 130/0...
November 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
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