Clinical review: The critical care management of the burn patient

Snell, Jane; Loh, Ne-Hooi Will; Mahambrey, Tushar; Shokrollahi, Kayvan

doi:10.1186/cc12706

Cited by 113 publications

(84 citation statements)

References 104 publications

(104 reference statements)

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“…Hypoalbuminemia in burn patients has been associated with complications initiated by abnormal disturbances in colloid and oncotic pressures resulting in increased extravascular fluid, edema, and subsequent compromise in wound healing. 18,19 Hypoalbuminemia has been implicated in sepsis susceptibility due to disrupted innate immunity and macrophage upregulation with increased proinflammatory productive capacity. 20 Sepsis in turn is a common complication of major burns, and likely to prolong the length of stay.…”

Section: Discussionmentioning

confidence: 99%

Lower Serum Albumin Shortly After Admission Predicts Prolonged Hospital Stay in Younger Burn Patients

Amavizca

Yang

Idicula

et al. 2016

Journal of Burn Care & Research

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The purpose of this study was to assess whether albumin levels could be used to aid in the prediction of hospital stay in adult burn patients. A retrospective review of burn patients from 2009 to 2014 was used. Demographic, injury details, albumin levels within 72 hours of admission, and clinical outcomes were recorded. The abbreviated burn severity index (ABSI) was calculated for each patient. Hospital stay >3 weeks was defined as "prolonged stay." Since albumin showed a significant interaction with age, patients were divided into two groups based on a median age of 40 years. Albumin, total BSA, and ABSI were each used as predictors, and the area under the curve (AUC) of a receiver operating characteristic curve was calculated. A composite score was created for the ≤ 40 years age group using ABSI and albumin levels to predict an increased length of stay. Thirty-eight of 198 (19.2%) patients had a stay >3 weeks. The AUCs for albumin level, total BSA, and ABSI alone in younger patients were 0.97, 0.97, and 0.96, respectively. Among patients older than 40, the AUC values were substantially lower indicating lower predictive value. The probability of prolonged stay for patients with albumin level ≥ 2.4 g/dl was low (.8%) compared with those with albumin level <2.4 g/dl (96.5%). Adding ABSI to this model increased predictive accuracy. Albumin level obtained within 72 hours of admission was an effective predictor of prolonged hospital stay in adult burn patients ≤ 40 years.

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Section: Discussionmentioning

confidence: 99%

Lower Serum Albumin Shortly After Admission Predicts Prolonged Hospital Stay in Younger Burn Patients

Amavizca

Yang

Idicula

et al. 2016

Journal of Burn Care & Research

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“…A small, retrospective, single-center study with 30 patients using historical controls and receiving the same ventilatory strategy found a 38% decrease in mortality and reduced lung injury scores when nebulized unfractionated heparin, N -acetylcysteine and albuterol sulfate were administered in comparison with albuterol. 84 A pediatric case series with historical controls similarly found a significant decrease in mortality, incidence of atelectasis and reintubation rate in a group treated with an alternating regime of aerosolized heparin alternating with 20% N -acetylcysteine solution. 84 Yet, a multicenter, prospective trial is still needed to confirm these data as reliable and reproducible before it can be accepted as a new standard of care.…”

Section: Lipoic Acidmentioning

confidence: 96%

Burns

Nielson

Duethman

Howard

et al. 2017

Journal of Burn Care & Research

233

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As a result of many years of research, the intricate cellular mechanisms of burn injury are slowly becoming clear. Yet, knowledge of these cellular mechanisms and a multitude of resulting studies have often failed to translate into improved clinical treatment for burn injuries. Perhaps the most valuable information to date is the years of clinical experience and observations in the management and treatment of patients, which has contributed to a gradual improvement in reported outcomes of mortality. This review provides a discussion of the cellular mechanisms and pathways involved in burn injury, resultant systemic effects on organ systems, current management and treatment, and potential therapies that we may see implemented in the future.

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“…Aerosols and some sprays can be expressed directly into the mouth or nose. [14,15] Exposure to a VS can affect multiple organs, such as the central nervous system, myocardium, liver, spleen, and kidneys. The gas leaves the body via exhalation.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Analysis of Patients Treated for Volatile Substance Burn Injuries

Yüce¹

2018

South Clin Ist Euras

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Objective: Volatile substance (VS) abuse has been defined as the use of chemical substances for non-medical purposes to achieve alterations in psychological functioning. Injury caused by VS abuse is an independent injury in and of itself; however, it is often combined with cutaneous burns, which are associated with increased morbidity and mortality. The aim of this study was to analyze the management of VS burn injuries referred to a burn center. Methods:The records of 67 patients with VS burns who were hospitalized in a tertiary educating and training hospital burn center between July 2012 and July 2017 were analyzed in a retrospective study after receiving institutional ethical approval. The age, gender, injury type, and case management were retrospectively studied. Results:All of the patients were young men, and most had a superficial burn injury. The length of stay in hospital ranged from 3 days to 22 days. In all, 8 patients (11.9%) were followed-up in the burn intensive care unit. All of the patients were treated with conservative management, and there was no mortality. Conclusion:Preventing the abuse of inhalants can prevent the occurrence of this type of burn. The development and evaluation of strategies for the treatment of chronic abusers and for the prevention of inhalant use are major challenges for the future.

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Clinical review: The critical care management of the burn patient

Cited by 113 publications

References 104 publications

Lower Serum Albumin Shortly After Admission Predicts Prolonged Hospital Stay in Younger Burn Patients

Lower Serum Albumin Shortly After Admission Predicts Prolonged Hospital Stay in Younger Burn Patients

Burns

Retrospective Analysis of Patients Treated for Volatile Substance Burn Injuries

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