Hepatic Functional Pathophysiology and Morphological Damage Following Severe Burns: A Systematic Review and Meta-analysis

Tapking, Christian; Kilian, Katja; Hundeshagen, Gabriel; Haug, Valentin; Teufel, Andreas; Houschyar, Khosrow Siamak; Kneser, Ulrich; Hirche, Christoph

doi:10.1093/jbcr/irab239

Cited by 2 publications

(2 citation statements)

References 83 publications

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“… 92 , 93 , 94 Fatty infiltration was found in 82% of patients undergoing liver biopsies and in 18% of patients with hepatic necrosis. 94 Gastrointestinal complications occur frequently in burn patients, and although the causal relationship is not clear in the previous reports, 25% of severe burns are considered affected by ulceration, bleeding, perforation, and mesenteric infarction. 95 , 96 Muschitz et al.…”

Section: Acute and Late Complications Of Burnsmentioning

confidence: 99%

Systemic immune response of burns from the acute to chronic phase

Osuka,

Shigeno,

Matsuura

et al. 2024

Acute Medicine & Surgery

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Immune responses that occur following burn injury comprise a series of reactions that are activated in response to damaged autologous tissues, followed by removal of damaged tissues and foreign pathogens such as invading bacteria, and tissue repair. These immune responses are considered to be programmed in living organisms. Developments of modern medicine have led to the saving of burned patients who could not be cured previously; however, the programmed response is no longer able to keep up, and various problems have arisen. This paper describes the mechanism of immune response specific to burn injury and the emerging concept of persistent inflammation, immunosuppression, and catabolism syndrome.

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Section: Acute and Late Complications Of Burnsmentioning

confidence: 99%

Systemic immune response of burns from the acute to chronic phase

Osuka,

Shigeno,

Matsuura

et al. 2024

Acute Medicine & Surgery

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“…However, sedation and analgesia protocols are aimed more at relieving the patient’s pain but not at reducing the patient’s organ damage ( 17 ). Although studies have shown that severe burns can cause multiple organ damage, including liver and lung ( 18 , 19 ), there is a lack of clinically targeted treatment to reduce organ damage in patients after severe burns. Fentanyl is an opioid analgesic; midazolam is a short-acting benzodiazepine sedative.…”

Section: Introductionmentioning

confidence: 99%

Histamine H1 receptor antagonist attenuates catecholamine surge and organ injury after severe burns

Wang

Liu

et al. 2023

Front. Endocrinol.

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Severe burns induce a catecholamine surge, causing severe damage to the organism and raising the possibility of multisystem organ failure. Few strategies are generally acceptable to reduce catecholamine surge and organ injury post-burn. We have previously shown that histamine can amplify the catecholamine surge. In addition, promethazine, a first-generation histamine H1 receptor antagonist, alleviates catecholamine surge and organ injury after severe burns in rats. However, evidence is lacking on whether promethazine benefits patients after severe burns. Currently, sedation and analgesia (such as midazolam and fentanyl) are commonly required for patients after severe burns. It remains unclear if patients after severe burns derive clinical benefit from histamine H1 receptor antagonists combined with sedation and analgesia. This study investigates the therapeutic effect of promethazine on patients after severe burns. Moreover, we test the therapeutic effect of cetirizine, a second-generation histamine H1 receptor antagonist, combined with sedation and analgesia in rats after severe burns. We find that promethazine-pethidine treatment shows a tendency for a lower level of total bilirubin than midazolam-fentanyl in patients 7-day after severe burn. Our study confirms that cetirizine combined with midazolam and fentanyl reduces catecholamine surge and liver and lung damage after severe burns in rats; the effects are better than midazolam and fentanyl treatment. In summary, for the first time, we suggest that histamine H1 receptor antagonist has the potential clinical value of reducing liver injury in patients after severe burns. In addition, we reveal that cetirizine combined with midazolam and fentanyl may be an ideal strategy for treating severe burns.

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Hepatic Functional Pathophysiology and Morphological Damage Following Severe Burns: A Systematic Review and Meta-analysis

Cited by 2 publications

References 83 publications

Systemic immune response of burns from the acute to chronic phase

Systemic immune response of burns from the acute to chronic phase

Histamine H1 receptor antagonist attenuates catecholamine surge and organ injury after severe burns

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