Respiratory failure after pediatric scald injury

A systematic review on intra-abdominal pressure in severely burned patients

“…In 21 case reports and series, a mortality rate of 50% among 58 burn ACS patients was seen (2,3,5,12,16,(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) (Table 4). Nine cohort studies (N=132 total) report mortality rates between 44%-100%, with a weighted average of 74.8% (18,19,(39)(40)(41)(42)(43)(44)(45) (Table 5).…”

Airway compromise in children with anterior neck burns: Beware the scalded child

“…As flame and explosion injuries have been well recognised to be associated with potential airway compromise and inhalational injury, a thorough airway assessment has generally been promptly undertaken by emergency service health‐care providers . Scald injuries, however, appear rarely recognised as causing significant airway problems, unless scalding fluids are ingested, aspirated or contain noxious gases …”

“…It must be recognised that while early airway assessment risk remains essential, the implications of not recognising an airway at risk or conversely of intubating unnecessarily can have significant morbidity. Although airway compromise may be life threatening, complications secondary to intubation, such as ventilated associated pneumonia, remain common …”

“…[1][2][3]10 As flame and explosion injuries have been well recognised to be associated with potential airway compromise and inhalational injury, a thorough airway assessment has generally been promptly undertaken by emergency service health-care providers. 2,8,13 Scald injuries, however, appear rarely recognised as causing significant airway problems, 14 unless scalding fluids are ingested, aspirated or contain noxious gases. 12,[15][16][17][18][19] Our data have shown that burn injuries to the anterior neck from all mechanisms, including scalds, were implicated in subcutaneous and soft tissue oedema formation and airway compromise in children.…”

“…Although airway compromise may be life threatening, complications secondary to intubation, such as ventilated associated pneumonia, remain common. 14,26 When assessing a child with burn to the anterior neck from any mechanism, young children with proportionally smaller airways, those who have had overzealous intravenous fluid resuscitation and those children with a respiratory tract illness, should be have a thorough airway risk assessment undertaken. Airway risk prevention should include accurate calculation of % TBSA and diligent monitoring of fluid balance and urine output.…”