Medical and Surgical Care of Critical Burn Patients: A Comprehensive Review of Current Evidence and Practice

Abstract

Critically ill burn patients pose several unique challenges to care providers. The concepts of fluid resuscitation, nutritional management, organ support and wound care are rapidly evolving. There is a pressing need to review emerging evidence and incorporate these into practice for the effective management of burn patients. We have searched the PubMed and Google Scholar databases to review the current evidence on the acute care management of adult as well as paediatric burn patients. The rationales for current practices have been integrated into the review. The management of critically ill burn patients requires an in-depth knowledge of the pathophysiology of burn injury, a tailored approach for timely resuscitation, timely diagnosis of organ specific problems, and comprehensive wound care. This review will help the doctors and healthcare providers involved in the management of critical burn patients in their day-to-day practice.

Atendimento De Emergência Às Queimaduras Graves

“…Não deve ser usada água fria. Por fim, aqueles que não apresentam imunização prévia ao tétano devem receber uma dose do toxóide tetânico (DATTA et al, 2022).…”

“…Os critérios de admissão na UTI são aqueles pacientes com maior grau de queimaduras pelo corpo, geralmente acima de 20% do TBSA em adultos e de 10% em crianças ou idosos, rebaixamento do nível de consciência, choque e evidências de falência de órgãos. Salienta-se também que não se deve ficar limitado a esses critérios devendo ser analisado caso a caso (DATTA et al, 2022).…”

“…Na população pediátrica sinais como a retração supraesternal indicam falha respiratória e necessidade por intubação. Heparina, N-acetil cisteína (NAC), broncodilatadores e corticoides via nebulização são medicamentos usados para o tratamento de queimaduras inalatórias que ajudam na limpeza das vias aéreas, dilatação e diminuição da inflamação (DATTA et al, 2022).…”

Pediatric First-Degree Burn Management With Honey and 1% Silver Sulfadiazine (Ag-SD): Comparison and Contrast

“…Additionally, there is high-rate morbidity, prolonged hospital stays, and management of burn involves financial burden over healthcare. The treatment of burns increases substantial impediments to the healthcare system at the public and community levels around the globe, especially among low-income countries [29]. The number of global deaths due to burning was recorded as 120,000-265,000 per year, most importantly of which occurred in low-and middle-income countries (LMICs) [30,31].…”

“…A censorious segment of burn wound medical intervention is correcting fluid and electrolyte imbalance, nutritional intervention, organ support, wound care, and overall resuscitation [29,[77][78][79]. Additionally, burn wound management requires rapid healing with minimum scarring [25,[80][81][82][83].…”