Update on Severe Burn Management for the Intensivist

Lundy, Jonathan B.; Chung, Kevin K.; Pamplin, Jeremy; Ainsworth, Craig; Jeng, James C.; Friedman, Bruce

doi:10.1177/0885066615592346

Cited by 36 publications

(30 citation statements)

References 105 publications

(164 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Scalds from hot liquids and steam, building fires and flammable liquids and gases. Another kind is an inhalation injury that caused by breathing smoke (2) . Worldwide, around 96,000 children under the age of 20 are estimated to have been mortally injured as a result of burns due to fire in 2014.…”

Section: Introductionmentioning

confidence: 99%

Current Nursing Practices for Managing Children with Burn Injuries

Ibrahim

Abusaad

Elbilgahy

2018

IJND

View full text Add to dashboard Cite

Background: Burns are one of the most common forms of trauma in children. Providing adequate care for burnt children properly is the most important contribution to the successful management. Aim: This study aimed to describe the current nursing practice provided for managing children with burn injuries and to identify the most common causes of burn injuries among children. Method: A descriptive exploratory research design was utilized in the study. The study was carried out in burn unit at Plastic, Reconstructive and Burn Surgery Center and Mansoura International Hospital at Mansoura city on a convenient sample of 56 nurses and 100 pediatric patients. Tools: Data were collected by using three tools. Current nursing practices for managing children with burn injury structure questionnaire sheet, Burn care observation checklist and clinical data sheet for children with burn injury. Results: The most common cause of burn was boiling water, more than three quarter of studied nurses had poor knowledge about burn and its management, two fifth of them had competent practice about wound dressing, more than two third of studied nurses had competent practice about pain and there was statistical significance difference between severities of burn and children death . Conclusion: The present study indicated that, the nurses' knowledge regarding burn was poor and were incompetent in the care practice regarding burn injuries. Recommendations: There is a need for burn training program that should be provided to nurses in order to improve their knowledge and practices regarding burn management.

show abstract

Section: Introductionmentioning

confidence: 99%

Current Nursing Practices for Managing Children with Burn Injuries

Ibrahim

Abusaad

Elbilgahy

2018

IJND

View full text Add to dashboard Cite

show abstract

“…Accordingly, adequate early fluid resuscitation to compensate for intravascular volume deficits and to support organ perfusion is an essential cornerstone in the treatment of the severely burned patient (2–4). The current American Burn Association Consensus Guidelines recommend a crystalloid-based resuscitation strategy with 2–4 mL/kg/body weight/% burned total body surface area (TBSA) during the first 24 hours after injury to achieve resuscitation endpoints, such as urine output and hemodynamics (1).…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Responsiveness to Vasopressin and α1-Adrenergic Receptor Agonists After Burn Injury

Evans

Vana

LaPorte

et al. 2017

Journal of Burn Care & Research

View full text Add to dashboard Cite

Objective The effects of burn injury on cardiovascular responsiveness to vasoactive agents are not well understood. The aims of the present study were to determine whether burn injury alters cardiovascular reactivity to vasoactive drugs in vivo and intrinsic function of isolated mesenteric resistance arteries. Methods Anesthetized Sprague-Dawley rats were subjected to sham procedure or 30% total body surface area dorsal scald burn, followed by crystalloid resuscitation (Parkland Formula). At 24h, 72h, 96h, and 168h post-burn rats were re-anesthetized and the mean arterial blood pressure (MAP) responses to various doses of the α1-adrenergic receptor agonist phenylephrine and arginine vasopressin were tested. Mesenteric arteries were harvested from uninjured animals and at 24h and 168h post-burn. The responsiveness of arteries to phenylephrine and arginine vasopressin was tested by pressure myography. Dose response curves were generated and EC50 concentrations, Hill slopes and maximal effects were compared. Results The potency of phenylephrine to increase MAP was reduced 2-fold 24h post-burn (p<0.05 vs. sham) and gradually normalized at later time points. The reactivity of isolated arteries to phenylephrine was not significantly altered after burns. The potency of arginine vasopressin to increase MAP and to constrict isolated arteries was increased 2-3-fold at 24h post-burn (p<0.05) and normalized at later time points. Conclusions Burn injury differentially regulates vasopressor and blood pressure effects of α-adrenergic and vasopressin receptor agonists. Intrinsic vasopressin receptor reactivity of resistance arteries is sensitized early after burns. These findings will help to optimize resuscitation strategies and vasopressor use in difficult to resuscitate burn patients.

show abstract

“…ARDS is associated with high mortality and about one-third of patients die. In addition, in the United States, 1.25 million burn injuries occur every year and 5 to 35% suffer from concomitant smoke inhalation injuries [5,6]. Smoke inhalation frequently causes severe ARDS and significantly increases the mortality of burn victims.…”

Section: Introductionmentioning

confidence: 99%

Detailed investigation of volumetric analysis, densitometry, and fractal geometry based concepts in computer aided medical diagnoses

Obert¹,

Stamm²,

Goerner³

et al. 2016

Fractal Geometry and Nonlinear Anal in Med and Biol

View full text Add to dashboard Cite

Purpose: Automated image analysis tools have the potential to improve the objectivity of the diagnostic process. The study and improvement of the numerical methodologies behind these tools is, therefore, crucial. Volumetric, densitometric, and fractal analysis concepts were, thus, explored in the setting of computed tomography (CT) imaging of different lung morphologies. Material and methods:Thoracic CT scans were acquired for five sheep prior to and after smoke inhalation injury. Software was developed to segment the lungs from the digital image data and to estimate the morphometric parameters "volume", "Hounsfield unit-density" (HU), and "fractal dimension". These parameters were estimated for each scan, once from the complete dataset, covering the entire a range of -1000 to 399 HU, and once for 28 consecutive data subsets, with a width of 50 HU each. T-test statistics were used to investigate group differences "before" and "after" smoke inhalation, based on a 0.05 significance level.Results: For the complete data set, group differentiation into "before" and "after" smoke in-halation was feasible only with volumetric analysis. Analysis of 28 smaller HU subsets, on the other hand, allowed group differentiation with all three morphometric parameters. Conclusions:The analysis of small HU subsets can be helpful in differentiating groups and may be a useful approach for many image analysis projects.

show abstract

Update on Severe Burn Management for the Intensivist

Cited by 36 publications

References 105 publications

Current Nursing Practices for Managing Children with Burn Injuries

Current Nursing Practices for Managing Children with Burn Injuries

Cardiovascular Responsiveness to Vasopressin and α1-Adrenergic Receptor Agonists After Burn Injury

Detailed investigation of volumetric analysis, densitometry, and fractal geometry based concepts in computer aided medical diagnoses

Contact Info

Product

Resources

About