Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial
Impact of "opening the lung" ventilatory strategy on burn patients with acute respiratory distress syndrome.
The objective of this study was to investigate the feasibility and influence of opening the lung strategy ventilation on burned patients complicated with ARDS. ⋯ It is necessary to conduct further trials to find out the effectiveness of this ventilation strategy on burns injury induced ARDS.
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Extracorporeal Membrane Oxygenation (ECMO) has only recently been described in patients with burn injuries. We report the incidence and type of infections in critically ill burn and non-burn patients receiving ECMO. ⋯ This is the first study to describe the incidence of infection in burn injury patients who are undergoing ECMO. We observed an increase in infections in burn patients on ECMO compared to non-burn patients. ECMO remains a viable option for critically ill patients with burn injuries.
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Nearly 500 people were injured in the dust explosion at the Formosa Fun Coast water park in 2015, making it the accident with the largest number of burn victims in Taiwan. Severe burn injuries are often accompanied by long-term impacts on physical, psychological, social, occupational, and aesthetic wellness. Survivors usually require several years or even decades of medical rehabilitation and psychological counseling, which inevitably affect their quality of life (QoL). ⋯ Survivors with more severe symptoms had worse QoL and a higher risk of PTSD. The burn accident affected not only the injured individuals but also their entire families. In order to help injured individuals reintegrate into society and maintain better overall health, our study suggested providing family-based healthcare plans and necessary follow-up visits in a timely manner.
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Severely burned patients often suffer white blood cell and platelet drop following the injury. Though coagulopathy after burn injury have been reported, the association between leukopenia or thrombopenia and mortality is still unrevealed. To determine whether early drastic drops in white blood cells (WBCs) and platelets following injury can be prognostic markers in patients with major burns. ⋯ Early thrombopenia and lymphopenia were independent risk factors for 60-day mortality, and prolonged thrombopenia and monocytopenia were independent risk factors for mortality. These findings might shed light on mechanisms of immune response following severe burns.
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To determine the association between potential risk factors and multiple organ failure (MOF) in severe burn adult patients, we performed a secondary analysis of data from the "Inflammation and the Host Response to Injury" database, which included patients from six burn centers in the United States between 2003 and 2009. Three hundred twenty-two adult patients (aged ≥16 years) with severe burns (≥20.0% total body surface area [TBSA]) were included. MOF was defined according to the Denver score. ⋯ TBSA, age, lactate, and Denver score within 24h were associated with the late phase development of MOF. Thus, we have identified key risk factors for the onset of MOF after severe burn injury. Our findings contribute to the understanding of individualized treatment and will potentially allow for efficient allocation of resources and a lower threshold for admission to an intensive care unit, which can prevent the development of MOF and eventually reduce mortality.