Burns : journal of the International Society for Burn Injuries
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Severe burns might be followed by severe infection associated with high mortality. In this study, we aimed to identify changes in genes and processes across time points after burn via analyzing time series gene expression profiles in burn patients and control from the Gene Expression Omnibus (GEO). ⋯ Functional enrichment analysis of those DEGs indicated significant enrichment of inflammatory/immune related processes throughout time points after burn, while, samples at later time points were also closely associated with cell activation regulation related processes. Short time series expression analysis of overlapping genes among the four lists of DEGs screened out two temporal gene expression profiles that exhibited decreasing and increasing expression trend across times after burn, and genes contained in those two profiles might be related to pathologic changes after severe burn.
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Discussions regarding withdrawal of life support after burn injury are challenging and complex. Often, providers may facilitate this discussion when the extent of injury makes survival highly unlikely or when the patient's condition deteriorates during resuscitation. Few papers have evaluated withdrawal of life support in burn patients. We therefore sought to determine the predictor of withdrawal of life support (WLS) in a regional burn center. ⋯ The decision to withdraw life support is a complex and difficult decision. Our current understanding of predictors of withdrawal of life support suggests that they mirror those factors which increase a patient's risk of mortality. Further research is needed to fully explore end-of-life decision making in regards to burn patients. The role of patient's sex, particularly women, in WLS decision making needs to be further explored.
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The objective of this study is to identify what burn survivors and front-line staff indicate would improve satisfaction with burn dressings, and the ranking of importance of different burn dressing characteristics. These findings will guide the development of future dressings to meet these needs. ⋯ Our study suggests that burn survivors and front-line burn providers have similar views on what constitutes an ideal dressing. A significantly proportion of caregiver/survivors felt that pain associated with dressing changes is being adequately managed despite healthcare providers' perception.
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Vancomycin empirical dosing studies in thermally injured patients have netted low successful target attainment and most excluded renal dysfunction, limiting applicability. In a previous study, the authors performed a retrospective analysis of 124 patients' measured pharmacokinetic parameters to calculate optimal dose and interval for intermittent infusion regimens and find predictors of clearance and total daily dose. The objective of this study was to improve the accuracy of attaining goal therapeutic targets with initial vancomycin regimens in patients with thermal injury through retrospective modeling. ⋯ The algorithm that resulted in the highest target attainment without overdosing recommended 15mg/kg dosed every 24h for CrCl≥30, every 12h for CrCl 31-79, every 8h for patients with CrCl≥80ml/min, and every 6h only if the patient with a CrCl≥80ml/min is also≤40 years old and has a SCr≤0.8. Caution is warranted for groups underrepresented in this study, such as those with very low CrCl, a low BMI, or receiving renal replacement therapy. This algorithm should be validated in other centers for patients with thermal injuries.
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The objective of this study is to broaden our understanding of psychiatric disorders due to work-related burn injury compensated by the Industrial Accident Compensation Insurance operated by the Korea Workers' Compensation and Welfare Service (KCOMWEL). ⋯ We analyzed the characteristics of the psychiatric disorders due to work-related burn injury for which compensation was received from 2005 to 2014 according to the approved results. To gain a long-term understanding of the management of workers' compensation status for psychiatric disorders due to work-related burn injuries, we should gather accurate information on the risk factors involved in order to achieve the needed systematic improvements.