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Management of Critical Burn Injuries: Recent Developments
BACKGROUND: Burn injury and its subsequent multisystem effects are commonly encountered by acute care practitioners. Resuscitation is the major component of initial burn care and must be managed to restore and preserve vital organ function. Later complications of burn injury are dominated by infecti...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Society of Critical Care Medicine
2017
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6786736/ https://www.ncbi.nlm.nih.gov/pubmed/31723611 http://dx.doi.org/10.4266/kjccm.2016.00969 |
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author | Dries, David J. Marini, John J. |
author_facet | Dries, David J. Marini, John J. |
author_sort | Dries, David J. |
collection | PubMed |
description | BACKGROUND: Burn injury and its subsequent multisystem effects are commonly encountered by acute care practitioners. Resuscitation is the major component of initial burn care and must be managed to restore and preserve vital organ function. Later complications of burn injury are dominated by infection. Burn centers are often called to manage problems related to thermal injury, including lightning and electrical injuries. METHODS: A selected review is provided of key management concepts as well as of recent reports published by the American Burn Association. RESULTS: The burn-injured patient is easily and frequently over resuscitated, with ensuing complications that include delayed wound healing and respiratory compromise. A feedback protocol designed to limit the occurrence of excessive resuscitation has been proposed, but no new “gold standard” for resuscitation has replaced the venerated Parkland formula. While new medical therapies have been proposed for patients sustaining inhalation injury, a paradigm-shifting standard of medical therapy has not emerged. Renal failure as a specific contributor to adverse outcome in burns has been reinforced by recent data. Of special problems addressed in burn centers, electrical injuries pose multisystem physiologic challenges and do not fit typical scoring systems. CONCLUSION: Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury has been generally adopted, but new standards for description of burn-related infections have been presented. The value of the burn center in care of the problems of electrical exposure, both manmade and natural, is demonstrated in recent reports. |
format | Online Article Text |
id | pubmed-6786736 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Korean Society of Critical Care Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-67867362019-11-13 Management of Critical Burn Injuries: Recent Developments Dries, David J. Marini, John J. Korean J Crit Care Med Review BACKGROUND: Burn injury and its subsequent multisystem effects are commonly encountered by acute care practitioners. Resuscitation is the major component of initial burn care and must be managed to restore and preserve vital organ function. Later complications of burn injury are dominated by infection. Burn centers are often called to manage problems related to thermal injury, including lightning and electrical injuries. METHODS: A selected review is provided of key management concepts as well as of recent reports published by the American Burn Association. RESULTS: The burn-injured patient is easily and frequently over resuscitated, with ensuing complications that include delayed wound healing and respiratory compromise. A feedback protocol designed to limit the occurrence of excessive resuscitation has been proposed, but no new “gold standard” for resuscitation has replaced the venerated Parkland formula. While new medical therapies have been proposed for patients sustaining inhalation injury, a paradigm-shifting standard of medical therapy has not emerged. Renal failure as a specific contributor to adverse outcome in burns has been reinforced by recent data. Of special problems addressed in burn centers, electrical injuries pose multisystem physiologic challenges and do not fit typical scoring systems. CONCLUSION: Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury has been generally adopted, but new standards for description of burn-related infections have been presented. The value of the burn center in care of the problems of electrical exposure, both manmade and natural, is demonstrated in recent reports. Korean Society of Critical Care Medicine 2017-02 2017-02-17 /pmc/articles/PMC6786736/ /pubmed/31723611 http://dx.doi.org/10.4266/kjccm.2016.00969 Text en Copyright © 2017 The Korean Society of Critical Care Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Dries, David J. Marini, John J. Management of Critical Burn Injuries: Recent Developments |
title | Management of Critical Burn Injuries: Recent Developments |
title_full | Management of Critical Burn Injuries: Recent Developments |
title_fullStr | Management of Critical Burn Injuries: Recent Developments |
title_full_unstemmed | Management of Critical Burn Injuries: Recent Developments |
title_short | Management of Critical Burn Injuries: Recent Developments |
title_sort | management of critical burn injuries: recent developments |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6786736/ https://www.ncbi.nlm.nih.gov/pubmed/31723611 http://dx.doi.org/10.4266/kjccm.2016.00969 |
work_keys_str_mv | AT driesdavidj managementofcriticalburninjuriesrecentdevelopments AT marinijohnj managementofcriticalburninjuriesrecentdevelopments |