Burns : journal of the International Society for Burn Injuries
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Burn survivors undergoing complex glycemic derangements in the acute period after burn are at significantly increased risk of worse outcomes. Although most critical care investigations recommend intensive glycemic control to prevent morbidity and mortality, conflicting recommendations exist. To date, no literature review has studied outcomes associated with intensive glucose control in the burn intensive care unit (ICU) population. ⋯ A majority of the studies (6/8) reported higher risk for hypoglycemia with tight glucose control, but few reported instances of adverse sequela associated with hypoglycemia. Intensive glucose control may provide benefit to burn patients, but complications associated with hypoglycemia must be considered. This review recommends an individualized patient-centered approach factoring comorbidities, burn injury characteristics, and risk factors when determining whether to employ intensive glucose control.
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Carbon monoxide (CO) is an odorless and colorless gas that can lead to fulminant and life-threatening intoxications. Besides an early diagnosis, an appropriate treatment of the intoxication is important. ⋯ However, the benefit of HBO in CO intoxications is still considered controversial. In this review, we discuss the evidence of the role of HBO treatment in isolated CO intoxication.
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To evaluate the loss of lean mass in patients with burns using ultrasonography of the quadriceps muscle of the thigh. ⋯ Muscle loss occurred early and rapidly within the first seven days of hospitalization, reflecting the impact of burn injury on nutritional risk. An association was observed between muscle thickness loss and age, but no association was observed with the extent of burn, length of hospital stay, occurrence of health-related infections or mortality. These findings suggest the importance of monitoring muscle loss in these patients in planning nutritional therapy, early mobilization, and prevention of complications.
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Observational Study
Laser speckle contrast imaging, an alternative to laser doppler imaging in clinical practice of burn wound care derivation of a color code.
To develop a color code and to investigate the validity of Laser Speckle Contrast Imaging (LSCI) for measuring burn wound healing potential (HP) in burn patients as compared to the reference standard Laser Doppler Imaging (LDI). ⋯ This is the first study in which a color code for the LSCI in adult clinical burn patients has been developed. Our study reconfirms the good performance of the LSCI for prediction of burn wound healing potential. This provides additional evidence for the potential value of the LSCI in specialized burn care.