Acute and Critical Care

Original Articles

Immunology
Serum procalcitonin and C-reactive protein as indices of early sepsis and mortality in North Indian pediatric burn injuries: a prospective evaluation and literature review: Nupur Aggarwal, Durga Karki, Rajni Gaind, Monika Matlani, Vamseedharan Muthukumar; Acute Crit Care. 2024;39(3):350-358. Published online August 30, 2024; DOI: https://doi.org/10.4266/acc.2023.00759

1,288 View
188 Download

Abstract PDF: Background
Delays in diagnosing sepsis in children afflicted with thermal injuries can result in high morbidity and mortality. Our study evaluated the role of the biomarkers Procalcitonin (PCT) and C-reactive protein (CRP) as predictors of early sepsis and mortality, respectively, in this group of patients. Methods: This was a prospective evaluation of 90 pediatric burn cases treated at a tertiary care burn center in Northern India. Patients, aged 1–16 years, presenting within 24 hours of being burned, with >10% body surface area of burn injury were included in the study. Levels of PCT and CRP were measured on days 1, 3, 5, and 7. Patients were followed until discharge, 30th post-burn day, or death, whichever occurred first. Results: Sepsis was clinically present in 49 of 90 (54.4%) cases with a median 30% total body surface area (TBSA) of burns. Mortality was seen in 31 of 90 (34.4%) cases with a median of 35% TBSA burns. High PCT and CRP were seen in the sepsis group, particularly on days 3, 5, and 7. PCT was also significantly higher in the mortality group (days 1 and 3). Conclusions: While PCT was a good early predictor of sepsis and mortality in children with burns, CRP was reliable as a predictor of sepsis only. Both markers, however, can serve as adjuncts to culture sensitivity reports for diagnosing early onset sepsis and initiation of antibiotic therapy in appropriate patients.

Trauma
Lund and Browder chart—modified versus original: a comparative study: Arun Murari, Kaushal Neelam Singh; Acute Crit Care. 2019;34(4):276-281. Published online November 29, 2019; DOI: https://doi.org/10.4266/acc.2019.00647

20,801 View
568 Download
22 Web of Science
24 Crossref

Background
The Lund and Browder (LB) chart is currently the most accurate and widely used chart to calculate total body surface area affected by a burn injury. However, it is not easy to use charts to calculate burn percentages because of the difficulty in performing mathematical calculations with the percentages attributed to various body regions that are only partially burned. It is also cumbersome to have to perform mental calculations, especially in emergency situations.
Methods
We compared results from the LB chart with a modified Lund and Browder (MLB) chart using 10 assessors on five different burn wounds each drawn on both charts.
Results
Variability of results was significantly reduced using the MLB chart compared to the LB chart.
Conclusions
Assessments performed using the MLB chart are less variable than those using the LB chart. Using this chart will help burn care providers rapidly, accurately, and reliably estimate burn extent.

Citations

Citations to this article as recorded by

Evolution of Burn Care
Martin R. Buta, Matthias B. Donelan
Clinics in Plastic Surgery.2024; 51(2): 191. CrossRef
Recent alcohol intake impacts microbiota in adult burn patients
Andrew J. Hoisington, Kevin Choy, Shanawaj Khair, Kiran U. Dyamenahalli, Kevin M. Najarro, Arek J. Wiktor, Daniel N. Frank, Ellen L. Burnham, Rachel H. McMahan, Elizabeth J. Kovacs
Alcohol.2024; 118: 25. CrossRef
Insight on Pediatric Burn Morbidity and Mortality at a Tertiary Indian Burn Care Center: A Case for Burn Prevention
Neeraj Kumar, Zachary J Eisner, Shivangi Saha, Vinay Kumar, Maneesh Singhal
Journal of Burn Care & Research.2024;[Epub] CrossRef
Prognostication of the development of septic complications in children with burn injuries
Olena Yu. Sorokina, Hennadii I. Posternak, Mariia G. Koval
Wiadomości Lekarskie.2024; 77(5): 1018. CrossRef
Psoriasis With Leg Involvement, a New Difficult-to-Treat Area: A Cohort Study of Patients Treated With Risankizumab
Federico Bardazzi, Federica Filippi, Martina Mussi, Claudia Lasagni, Laura Bigi, Giulia Odorici, Francesca Peccerillo, Miriam Rovesti, Francesca Satolli, Michela Tabanelli, Sandra Schianchi, Vito Di Lernia, Marco Manfredini
Dermatology Practical & Conceptual.2024; : e2024171. CrossRef
Surface anatomy in dermatology: Part I—Clinical importance, diagnostic utility, and impact on medical management
Eric J. Beltrami, Christian Gronbeck, Neelesh Jain, Geneva Hargis, Hao Feng, Jane M. Grant-Kels, Brett Sloan
Journal of the American Academy of Dermatology.2024; 91(2): 207. CrossRef
FireSync EMS: A Novel Mobile Application for Burn Surface Area Calculation
Nicolas Malkoff, Brigette Cannata, Sarah Wang, Artur Manasyan, Joseph Maestas, Trevor A Pickering, Lyle Koegler, Saman Kashani, Maxwell B Johnson, Haig A Yenikomshian, T Justin Gillenwater
Journal of Burn Care & Research.2024;[Epub] CrossRef
Brûlures : étiologies et gravité
Damien Malbos
Actualités Pharmaceutiques.2024; 63(641): 29. CrossRef
EasyTBSA as a method for calculating total body surface area burned: a validation study
Cindy D Colson, Emily C Alberto, Zachary P Milestone, Nikita Batra, Tyler Salvador, Hadi Fooladi, Kevin Cleary, Rima Izem, Randall S Burd
Emergency Medicine Journal.2023; 40(4): 279. CrossRef
Temporal trends in burn size estimation and the impact of the NSW Trauma App on estimation accuracy
Thanya Sritharan, Morgan Haines, Anne Darton, Aruna Wijewardana, Diane Elfleet, Kate Welsh, Meredeth Cassidy, Bish Soliman, Shane O’Neill, Jeon Cha, John Vandervord, Varun Harish
Burns.2023; 49(6): 1403. CrossRef
Treatment of Pediatric Upper Extremity Burns
Carrie L. Roth Bettlach, Courtney Bergheger, Lauren Jacobson, Mitchell A. Pet
The Journal for Nurse Practitioners.2023; 19(3): 104536. CrossRef
Evaluation and Optimization of the Wallace Rule of Nines for the Estimation of Total Body Surface Area in Obese and Nonobese Populations
Daniel Iván García-Ballesteros, Delia Del Carmen Rivera-Martínez, Mauricio Manuel García-Pérez, Everardo Valdés-Flores, Yanko Castro-Govea, Hernán Jesús Chacón-Moreno
The Journal of Emergency Medicine.2023; 65(4): e320. CrossRef
Clinical Profile of Children with Burns in a Tertiary Care Hospital
AV Lalitha, K Yashaswini, GS Naresh Kanna, Abha Rani Kujur, John A Michael Raj
Indian Journal of Critical Care Medicine.2023; 27(12): 934. CrossRef
A 1% TBSA Chart Reduces Math Errors While Retaining Acceptable First-Estimate Accuracy
William C Ray, Adrian Rajab, Hope Alexander, Brianna Chmil, Robert Wolfgang Rumpf, Rajan Thakkar, Madhubalan Viswanathan, Renata Fabia
Journal of Burn Care & Research.2022; 43(3): 665. CrossRef
Body mapping chart for estimation of percentage of body surface area in mesocephalic dogs
Andrea Henriksson, Kendon Kuo, Katherine Gerken, Kelsey Cline, Adrien‐Maxence Hespel, Robert Cole, Rachel Moon
Journal of Veterinary Emergency and Critical Care.2022; 32(3): 350. CrossRef
The Nursing Effect of Different Dressings on Local Small Area Burn Wound
娟李
Nursing Science.2022; 11(02): 279. CrossRef
Integrating the Patient's Voice in Toxicity Reporting and Treatment Decisions for Breast Radiotherapy
Sara R. Alcorn, Kimberly S. Corbin, Dean A. Shumway
Seminars in Radiation Oncology.2022; 32(3): 207. CrossRef
The relationships between routine admission blood tests and burn size, and length of stay in intensive care unit
Eng-Kean Yeong, Kwang-Yi Tung, Chin-Hao Chang, Shang-Jie Tsai
Journal of the Formosan Medical Association.2022; 121(12): 2512. CrossRef
Estimation of percent body surface area in cats with use of computed tomography
Andrea Henriksson, Jack Hamersky, Kendon Kuo, Katherine Gerken, Rachel Moon
Journal of Veterinary Emergency and Critical Care.2022; 32(6): 743. CrossRef
Effect of Different Itraconazole Dosing Regimens on Cure Rates, Treatment Duration, Safety, and Relapse Rates in Adult Patients With Tinea Corporis/Cruris
Ananta Khurana, Aastha Agarwal, Diksha Agrawal, Sanjeet Panesar, Manik Ghadlinge, Kabir Sardana, Khushboo Sethia, Shalini Malhotra, Ankit Chauhan, Nirmala Mehta
JAMA Dermatology.2022; 158(11): 1269. CrossRef
Hallway Gait Monitoring System Using an In-Package Integrated Dielectric Lens Paired with a mm-Wave Radar
Hajar Abedi, Jennifer Boger, Plinio Pelegrini Morita, Alexander Wong, George Shaker
Sensors.2022; 23(1): 71. CrossRef
To compare the effect of sea buckthorn and silver sulfadiazine dressing on period of wound healing in patients with second‐degree burns: A randomized triple‐blind clinical trial
Mehrdad Abdullahzadeh, Saeed Shafiee
Wound Repair and Regeneration.2021; 29(5): 732. CrossRef
State of the Art: An Update on Adult Burn Resuscitation
Jacqueline M. Causbie, Lauren A. Sattler, Anthony P. Basel, Garrett W. Britton, Leopoldo C. Cancio
European Burn Journal.2021; 2(3): 152. CrossRef
Lifetime Ambient UV Radiation Exposure and Risk of Basal Cell Carcinoma by Anatomic Site in a Nationwide U.S. Cohort, 1983–2005
Mark P. Little, Terrence Lee, Michael G. Kimlin, Cari M. Kitahara, Rui Zhang, Bruce H. Alexander, Martha S. Linet, Elizabeth K. Cahoon
Cancer Epidemiology, Biomarkers & Prevention.2021; 30(10): 1932. CrossRef

Review Article

Surgery
Management of Critical Burn Injuries: Recent Developments: David J. Dries, John J. Marini; Korean J Crit Care Med. 2017;32(1):9-21. Published online February 17, 2017; DOI: https://doi.org/10.4266/kjccm.2016.00969

26,909 View
1,573 Download
8 Web of Science
5 Crossref

Abstract PDF

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.

Citations

Citations to this article as recorded by

Prevalence and Trend of Depression in Burn Survivors: A Single Center Cohort Study
V S Ranganath, Smitha Segu, B S Girish, Joel M Johns, C S Meghana
Journal of Burn Care & Research.2024; 45(4): 958. CrossRef
Гиповолемический шок у взрослых. Клинические рекомендации Общероссийской общественной организации «Федерация анестезиологов и реаниматологов»
Игорь Борисович Заболотских, Е. В. Григорьев, В. С. Афончиков, А. Ю. Буланов, С. В. Григорьев, А. Н. Кузовлев, В. В. Кузьков, Р. Е. Лахин, К. М. Лебединский, О. В. Орлова, Е. В. Ройтман, С. В. Синьков, Н. П. Шень, А. В. Щеголев
Annals of Critical Care.2024; (4): 7. CrossRef
SUBMICROSCOPIC CHANGES IN THE HEMOCAPILLARIES OF THE CEREBRAL HEMISCLE CAUSES CAUSED BY THERMAL BURN
H. V. Lukyantseva, V. A. Pastukhova, O. I. Kovalchuk
Bulletin of Problems Biology and Medicine.2021; 3(1): 268. CrossRef
Kefir Accelerates Burn Wound Healing Through Inducing Fibroblast Cell Migration In Vitro and Modulating the Expression of IL-1ß, TGF-ß1, and bFGF Genes In Vivo
Ahmad Oryan, Esmat Alemzadeh, Mohammad Hadi Eskandari
Probiotics and Antimicrobial Proteins.2019; 11(3): 874. CrossRef
Viable placental allograft as a biological dressing in the clinical management of full-thickness thermal occupational burns
Eric L. Johnson, Elisabet K. Tassis, Georgina M. Michael, Susan G. Whittinghill
Medicine.2017; 96(49): e9045. CrossRef

Original Article

Diagnosis of Acid-base Imbalance by Stewart's Physicochemical Approach and Mortality Prediction in Severe Burn Patients with Inhalation Injury: Sunghoon Park, Cheol Hong Kim, In Gyu Hyun, Ki Suck Jung; Korean J Crit Care Med. 2006;21(1):17-27.

2,578 View
59 Download

Abstract PDF: BACKGROUND
Acid-base derangement are commonly encountered in critically ill patients. This study is to investigate underlying mechanisms of acid-base imbalance and also to examine whether they can predict mortality in burn patients.
METHODS
We retrospectively reviewed 73 severely burned patients who had admitted to burn intensive care unit, from January to July in 2004. All the patients had inhalation injury, identified by bronchoscopic examination. We analyzed the type and nature of the acid-base imbalances from arterial blood gas analysis, electrolytes and other biological tests between survivors and non-survivors for 30 days after admission.
RESULTS
Acidosis was the most common disorder during the early and late hospital periods. Large fractions of those showed decreased strong ion difference (SID), increased anion gap corrected by albumin (AGc) and [Cl-]corrected. Mixed disorder and alkalosis emerged after the 7(th) hospital day. As time went by, albumin, PaO2/FiO2 ratio, pH and SID were more decreased in non-survivors (n=28) than in survivors (n=45) while [Cl-] corrected, alveolar-arterial oxygen tension gradients, peripheral WBC counts and CRP were more increased in non-survivors than in survivors. In the area under the receiver operating characteristic curves for mortality prediction, APACHE II score and % of total body surface area (%TBSA) burn were high: 0.866 (95% CI; 0.785~0.946) for APACHE II score, 0.817 (95% CI; 0.717~0.918) for %TBSA burn.
CONCLUSIONS
In burned patients with inhalation injury, various types of acid-base imbalances and electrolytes abnormalities emerged after resuscitation and so, more careful attentions pursued for correcting underlying acid-base derangement.

First
Prev
Page of 1
Next
Last

Search