Concomittant Traumatic Brain Injury and Burns in Combat Trauma

Graybill, John Christopher; Aden, Jay; Rizzo, Julie A; Clemens, Michael S.; Janak, Jud C.; White, Christopher E.; Driscoll, Ian R.; Chung, Kyungsoon

doi:10.1016/j.jamcollsurg.2016.10.020

Cited by 4 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Iran is no exception to the effect of burn injuries on disability, so that according to the results of the study, burns have been the eighth cause of disability due to disease in the country 4 . In addition, traumatic injuries, commonly associated with burns, can increase disability as well as mortality 10 . Therefore, in this regard, in addition to preventing burns, any action for a better treatment approach and early diagnosis of traumatic injuries can reduce complications, disability and treatment costs.…”

Section: Discussionmentioning

confidence: 99%

“…This measure is important because it can first help determine the prognosis of patients and lead to better planning for the treatment of patients, because patients with burn injuries with TBI need advanced care and treatment with careful monitoring. TBI can lead to episodes of shock, pulmonary embolism, office infection, or bacteremia, and can increase the length of hospital stay or cause the use of a ventilator 10,11 . Although some studies have suggested TBI as an effective factor in increasing mortality 12 , there is disagreement in some studies 10 .…”

Section: Introductionmentioning

confidence: 99%

“…TBI can lead to episodes of shock, pulmonary embolism, office infection, or bacteremia, and can increase the length of hospital stay or cause the use of a ventilator 10,11 . Although some studies have suggested TBI as an effective factor in increasing mortality 12 , there is disagreement in some studies 10 . In addition, no comprehensive study has been conducted to investigate the role of TBI in mortality due to burn injury in children.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Traumatic Brain Injury in Child Burn

Sobouti

Ansari²,

Garahgheshlagh³

et al. 2022

WJPS

View full text Add to dashboard Cite

BACKGROUNDBurns are one of the most important health problems in communities. Traumatic injuries, especially Traumatic Brain Injury (TBI) associated with burns, may increase disability and mortality. In addition to preventing burns, any action for a better treatment approach and early detection of concomitant traumatic injuries can reduce complications, disability, and treatment costs. We aimed to investigate the outcome of children with burn injury with and without TBI. METHODSIn this cross-sectional study, 392 children with burn injuries treated at Motahari Hospital in Tehran, Iran from 2018-2019 were enrolled. Patient demographics, burn injury information and TBI-related information including head trauma and fracture were recorded in a checklist. Patients were divided into two groups of death (24 people) or discharge (368 people) in terms of outcome and the underlying variables were compared in the two groups. RESULTSThere was no significant difference between the mean age of patients and gender in the two groups. The difference in the length of hospital stay, inhalation injury and skull fracture in the two groups was not statistically significant. The mean burn severity based on Total Body Surface Area (TBSA) and the frequency of TBI in the deceased group was significantly higher (P=0.001). CONCLUSIONThe severity of burns based on TBSA and TBI is associated with increased mortality among children with burn injuries. The results suggest the need to examine children with burn injuries for TBI using clinical examination or imaging.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Traumatic Brain Injury in Child Burn

Sobouti

Ansari²,

Garahgheshlagh³

et al. 2022

WJPS

View full text Add to dashboard Cite

show abstract

“…Combined burn injury and TBI is a complex pattern of traumatic injury with a historically low incidence (7). Due to this low incidence, clinicians have been left to determine appropriate treatment approach in the absence of evidence or consensus guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…However, this injury pattern is increasing in the military population due to the increased use of improvised explosive devices (IED) in modern warfare. A review of 951 service members treated with burn injuries at the US Institute of Surgical Research burn center found 95 (10.0%) had a concomitant TBI (7). In this cohort, a combined burn injury and TBI was associated with increased complications including increased risk of intensive care unit stay, prolonged ventilation, higher rates of amputation, bacteremia, urinary tract infections, wound infections, and thromboembolism compared with isolated burn injury or TBI.…”

Section: Introductionmentioning

confidence: 94%

High Versus Low Volume Fluid Resuscitation Strategies in a Porcine Model (Sus scrofa) of Combined Thermal and Traumatic Brain Injury

Guenther

Spruce

Bach

et al. 2020

Shock

View full text Add to dashboard Cite

Background: Combined burn and traumatic brain injury (TBI) treatment priorities may not align due to opposing fluid resuscitation paradigms used in treating burns and TBI. We developed a porcine model of combined thermal injury/TBI and compared an ''aggressive'' fluid resuscitation strategy using the Parkland formula and a ''restrictive'' resuscitation strategy using the modified Brooke formula. Methods: Twenty-eight swine were deeply anesthetized and received a 40% total body surface area full-thickness burn injury and TBI. Swine were then randomized to receive restrictive or aggressive resuscitation for 8 h after which time animals were euthanized and necropsy was performed. Volume of brain injury was assessed after analyzing segmental slices of brain tissue. Results: There were no differences between the restrictive and aggressive resuscitation groups in blood pressure, heart rate, central venous pressure, intra-cranial pressure (ICP), or serum lactate levels after 8 h of resuscitation. Urine output was higher in the aggressive resuscitation group. The restrictive group had a significantly higher serum blood urea nitrogen (BUN) compared with baseline and compared with the aggressive group. There was no significant difference in size of brain injury between groups. Conclusions: Both restrictive and aggressive resuscitation demonstrated adequate resuscitation at 8 h postinjury. Increased serum BUN in the restrictive group may be an indicator of early acute kidney injury, despite adequate urine output. Resuscitation strategy did not appear to affect ICP or the size of brain injury.

show abstract