The Rational Care of Burns

Vercruysse, Gary

doi:10.1007/978-3-319-74672-2_15

Cited by 1 publication

(1 citation statement)

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“…Low cardiac output during the acute post-injury phase is a common component of early "burn shock" [162,163] and may be more pronounced among geriatric patients [164]. In some cases, inotropic support with dobutamine may be required to maintain adequate systemic perfusion [165,166]. Vasopressors should be avoided if possible as their vasoconstrictive properties can lead to decreased end-organ perfusion, including skin (and thus elevated risk of the propagation of primary injury or impaired healing of skin grafts) and bowel (e.g., contribution to potential bowel ischemia).…”

Section: Special Hemodynamic Considerationsmentioning

confidence: 99%

Burn Shock and Resuscitation: Many Priorities, One Goal

Sojka¹,

Krakowski²,

Stawicki³

2020

Clinical Management of Shock - The Science and Art of Physiological Restoration

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Burn injuries come in a wide variety of presentations, depending on the size and depth of the thermal insult, concurrent traumatic or inhalation injury, as well as the associated physiological response of the burn victim. To minimize patient morbidity and reduce mortality, prompt recognition and tailored treatment strategies are critically important. As the percentage of total body surface area (TBSA) burned increases so do the body's physiologic response and the associated complexity of management. Understanding the pathophysiology of burn injury allows the practitioner to optimize and individualize burn patient management-a component of care critical to limiting wound progression and improving outcomes. Burn patient care starts with an accurate and thorough burn patient evaluation conducted in person by an experienced provider. For burns >10-15% TBSA, prompt initiation of fluid resuscitation greatly impacts clinical outcomes. Several formulae have been published to guide crystalloid and/or colloid fluid resuscitation in the setting of burn shock. Other important considerations include ambient temperature control, early enteral nutritional support, vitamin and mineral supplementation, assessment for inhalation injury, glycemic control, early recognition of potential complications of large volume resuscitation, potential need for cardiovascular support, and early wound excision and coverage. Burn patients often require multidisciplinary teams to manage the physical, social, and psychological effects associated with their injury. Dedicated burn centers are the ideal places for meeting the complex needs of each burn patient.

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