Acute respiratory distress syndrome in wartime military burns

Abstract

Epidemiologic/prognostic study, level III.

Acute Respiratory Distress Syndrome in Burn Patients

“…On univariate analysis, the following variables were found to be significantly different among the various categories of ARDS when compared with no ARDS as defined by either definition: increasing age, %TBSA, %FT, II, ISS, 24-hour resuscitation fluid volume >250 ml/kg, AKI score ≥ 1, and pneumonia (Tables 2 and 3). 11,15 This present study suggested, on univariate analysis, a potential link between higher initial resuscitation fluid volume and ARDS, contrary to the previous finding in a military-only cohort. 11,15 However, multiple logistic regression failed to demonstrate an independent relationship between this variable and moderate or severe ARDS ( Table 4).…”

“…11,15 This present study suggested, on univariate analysis, a potential link between higher initial resuscitation fluid volume and ARDS, contrary to the previous finding in a military-only cohort. 11,15 However, multiple logistic regression failed to demonstrate an independent relationship between this variable and moderate or severe ARDS ( Table 4). The ARDS Definition Task Force validated the new Berlin definition in a large critical care population.…”

“…5,[9][10] An association between inhalation injury and ARDS has shown a variable relationship. [5][6]9,[11][12] Our group has previously reported the prevalence of ARDS among 291 wartime military burns on mechanical ventilation. 11 This retrospective study expands this evaluation by combining those military burns with a much larger cohort of civilian burn patients in an effort to determine the prevalence of ARDS in both populations, while comparing the Berlin definition to the AECC definition.…”

Elevations in inflammatory cytokines are associated with poor outcomes in mechanically ventilated burn patients

“…27 Despite improvements in patient support, mortality rates from ARDS in the mixed intensive care unit population remain approximately 40%. 28,29 With respect to severe burn, mortality is increased by approximately 20% with inhalation injury and 60% with additional pneumonia, 1 so burn patients with inhalation injury leading to concomitant pneumonia and/or ARDS have a significant risk of complications and demand unique approaches to improve patient care and survival.…”

Early Utilization of Extracorporeal CO2 Removal for Treatment of Acute Respiratory Distress Syndrome Due to Smoke Inhalation and Burns in Sheep

“…In thermally injured patients, inhalation injury is often associated with ARDS, and is an independent predictor of increased morbidity and mortality (20,21). Our goal was to examine the early application of the ECCO 2 R therapy in the setting of mild to moderate ARDS.…”