Predicting and managing sepsis in burn patients: current perspectives

Abstract

Modern burn care has led to unprecedented survival rates in burn patients whose injuries were fatal a few decades ago. Along with improved survival, new challenges have emerged in the management of burn patients. Infections top the list of the most common complication after burns, and sepsis is the leading cause of death in both adult and pediatric burn patients. The diagnosis and management of sepsis in burns is complex as a tremendous hypermetabolic response secondary to burn injury can be superimposed on systemic infection, leading to organ dysfunction. The management of a septic burn patient represents a challenging scenario that is commonly encountered by providers caring for burn patients despite preventive efforts. Here, we discuss the current perspectives in the diagnosis and treatment of sepsis and septic shock in burn patients.

<p>SEPSIS. Educational and Best Practice Frontiers. Beyond the Boundaries of Fatality, Enhancing Clinical Skills and Precision Medicine</p>

“…6,7 Applied bioinformatics and omics in clinical practice of sepsis are also limited by financial conditions. 8,9 According to the Iceberg Model of Health and Disease, what we see of illness and health, and what we know as events and deaths due to sepsis is only the tip of a submerged mass (Figure 1). Looking below the surface, much like icebergs that reveal only about one-tenth of their mass above the water and the other nine-tenths remains submerged, we can see that most diagnoses of sepsis are hidden in the official statistics.…”

“…Furthermore, the wider use of biomarkers for speeding diagnosis has already achieved some advantage providing earlier information, while waiting for the results of microbiological cultures and identification. 6,8 Nonetheless, current biomarkers may be quite insensitive and excessively generic for such purposes. In addition, their use for monitoring persistence of the critical phase may be unreliable.…”

Comparative Analysis of the Host Response in a Rat Model of Deep-Partial and Full-Thickness Burn Wounds With Pseudomonas aeruginosa Infection

“…Burn injury compromises the primary barrier of the host, the skin, which immediately places the host at risk for infection (Church et al, 2006;Kennedy et al, 2010;Lopez et al, 2017). This poses a particular threat to soldiers, who have limited access to immediate medical care at the point of injury, let alone a sterile surgical environment.…”

Concentration of procalcitonin in the blood serum and peritoneal exudate after operations in the abdominal cavity

“…Определение концентрации прокальцитонина (ПКТ) в сыворотке крови широко используется в комплексной диагностике сепсиса, а также для контроля за эффективностью антибактериальной терапии [1][2][3][4][5]. Однако до сих пор остается открытым вопрос о биологической роли этого соединения и его обмене в организме человека [6,7].…”

“…В большинстве публикаций приводятся данные о содержании ПКТ в сыворотке крови [1][2][3][4][5][6][7]. Данные о концентрации ПКТ в других биологических жидкостях организма человека, в частности в экссудатах и транссудатах, не столь многочисленны.…”