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3. Restrictive Transfusion Strategy Is More Effective in Massive Burns: Results of the TRIBE Multicenter Prospective Randomized Trial

Author

Palmieri, Tina L, Holmes, James H, Arnoldo, Brett, Peck, Michael, Cochran, Amalia, King, Booker T, Dominic, William, Cartotto, Robert, Bhavsar, Dhaval, Tredget, Edward, Stapelberg, Francois, Mozingo, David, Friedman, Bruce, Sen, Soman, Taylor, Sandra L, and Pollock, Brad H

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Trials and Supportive Activities, Clinical Research, Patient Safety, Physical Injury - Accidents and Adverse Effects, Good Health and Well Being, Adult, Blood Transfusion, Body Surface Area, Burns, Female, Guidelines as Topic, Health Policy, Humans, Length of Stay, Male, Middle Aged, Prospective Studies, burn treatment, blood transfusion, outcomes, infection, Human Movement and Sports Sciences, Public Health and Health Services, Strategic, Defence & Security Studies, Clinical sciences, Health services and systems
Abstract

ObjectivesStudies suggest that a restrictive transfusion strategy is safe in burns, yet the efficacy of a restrictive transfusion policy in massive burn injury is uncertain. Our objective: compare outcomes between massive burn (≥60% total body surface area (TBSA) burn) and major (20-59% TBSA) burn using a restrictive or a liberal blood transfusion strategy.MethodsPatients with burns ≥20% were block randomized by age and TBSA to a restrictive (transfuse hemoglobin 0.05).ConclusionsA restrictive transfusion strategy may be beneficial in massive burns in reducing ventilator days, ICU days and blood utilization, but does not decrease infection, mortality, hospital LOS or wound healing.

Published
2019

4. High-volume hemofiltration in adult burn patients with septic shock and acute kidney injury: a multicenter randomized controlled trial

Author

Chung, Kevin K, Coates, Elsa C, Smith, David J, Karlnoski, Rachel A, Hickerson, William L, Arnold-Ross, Angela L, Mosier, Michael J, Halerz, Marcia, Sprague, Amy M, Mullins, Robert F, Caruso, Daniel M, Albrecht, Marlene, Arnoldo, Brett D, Burris, Agnes M, Taylor, Sandra L, Wolf, Steven E, and for the Randomized controlled Evaluation of high-volume hemofiltration in adult burn patients with Septic shoCk and acUte kidnEy injury (RESCUE) Investigators

Subjects
Sepsis, Kidney Disease, Physical Injury - Accidents and Adverse Effects, Clinical Research, Hematology, Clinical Trials and Supportive Activities, Infectious Diseases, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, Inflammatory and immune system, Renal and urogenital, Acute Kidney Injury, Adult, Burns, Female, Hemofiltration, Humans, Male, Middle Aged, Multiple Organ Failure, Organ Dysfunction Scores, Prospective Studies, Renal Replacement Therapy, Shock, Septic, High-volume hemofiltration, Septic shock, Acute kidney injury, Randomized controlled trial, Multicenter, Randomized controlled Evaluation of high-volume hemofiltration in adult burn patients with Septic shoCk and acUte kidnEy injury (RESCUE) Investigators, Medical and Health Sciences, Emergency & Critical Care Medicine
Abstract

BackgroundSepsis and septic shock occur commonly in severe burns. Acute kidney injury (AKI) is also common and often results as a consequence of sepsis. Mortality is unacceptably high in burn patients who develop AKI requiring renal replacement therapy and is presumed to be even higher when combined with septic shock. We hypothesized that high-volume hemofiltration (HVHF) as a blood purification technique would be beneficial in this population.MethodsWe conducted a multicenter, prospective, randomized, controlled clinical trial to evaluate the impact of HVHF on the hemodynamic profile of burn patients with septic shock and AKI involving seven burn centers in the United States. Subjects randomized to the HVHF were prescribed a dose of 70 ml/kg/hour for 48 hours while control subjects were managed in standard fashion in accordance with local practices.ResultsDuring a 4-year period, a total of nine subjects were enrolled for the intervention during the ramp-in phase and 28 subjects were randomized, 14 each into the control and HVHF arms respectively. The study was terminated due to slow enrollment. Ramp-in subjects were included along with those randomized in the final analysis. Our primary endpoint, the vasopressor dependency index, decreased significantly at 48 hours compared to baseline in the HVHF group (p = 0.007) while it remained no different in the control arm. At 14 days, the multiple organ dysfunction syndrome score decreased significantly in the HVHF group when compared to the day of treatment initiation (p = 0.02). No changes in inflammatory markers were detected during the 48-hour intervention period. No significant difference in survival was detected. No differences in adverse events were noted between the groups.ConclusionsHVHF was effective in reversing shock and improving organ function in burn patients with septic shock and AKI, and appears safe. Whether reversal of shock in these patients can improve survival is yet to be determined.Trial registrationClinicaltrials.gov NCT01213914 . Registered 30 September 2010.

Published
2017

5. Transfusion Requirement in Burn Care Evaluation (TRIBE)

Author

Palmieri, Tina L, Holmes, James H, Arnoldo, Brett, Peck, Michael, Potenza, Bruce, Cochran, Amalia, King, Booker T, Dominic, William, Cartotto, Robert, Bhavsar, Dhaval, Kemalyan, Nathan, Tredget, Edward, Stapelberg, Francois, Mozingo, David, Friedman, Bruce, Greenhalgh, David G, Taylor, Sandra L, and Pollock, Brad H

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Hematology, Physical Injury - Accidents and Adverse Effects, Good Health and Well Being, Adolescent, Adult, Bacteremia, Blood Transfusion, Burns, Humans, Incidence, Infections, Length of Stay, Middle Aged, Multiple Organ Failure, Prospective Studies, Respiration, Artificial, Time Factors, Treatment Outcome, Wound Healing, Young Adult, blood transfusion, burn treatment, infection, outcomes, Medical and Health Sciences, Surgery, Clinical sciences
Abstract

ObjectiveOur objective was to compare outcomes of a restrictive to a liberal red cell transfusion strategy in 20% or more total body surface area (TBSA) burn patients. We hypothesized that the restrictive group would have less blood stream infection (BSI), organ dysfunction, and mortality.BackgroundPatients with major burns have major (>1 blood volume) transfusion requirements. Studies suggest that a restrictive blood transfusion strategy is equivalent to a liberal strategy. However, major burn injury is precluded from these studies. The optimal transfusion strategy in major burn injury is thus needed but remains unknown.MethodsThis prospective randomized multicenter trial block randomized patients to a restrictive (hemoglobin 7-8 g/dL) or liberal (hemoglobin 10-11 g/dL) transfusion strategy throughout hospitalization. Data collected included demographics, infections, transfusions, and outcomes.ResultsEighteen burn centers enrolled 345 patients with 20% or more TBSA burn similar in age, TBSA burn, and inhalation injury. A total of 7054 units blood were transfused. The restrictive group received fewer blood transfusions: mean 20.3 ± 32.7 units, median = 8 (interquartile range: 3, 24) versus mean 31.8 ± 44.3 units, median = 16 (interquartile range: 7, 40) in the liberal group (P < 0.0001, Wilcoxon rank sum). BSI incidence, organ dysfunction, ventilator days, and time to wound healing (P > 0.05) were similar. In addition, there was no 30-day mortality difference: 9.5% restrictive versus 8.5% liberal (P = 0.892, χ test).ConclusionsA restrictive transfusion strategy halved blood product utilization. Although the restrictive strategy did not decrease BSI, mortality, or organ dysfunction in major burn injury, these outcomes were no worse than the liberal strategy (Clinicaltrials.gov identifier NCT01079247).

Published
2017

9. 72 Multi-Spectral SWIR Imaging in Humans Reveals Correlations with Distinct Skin Burn Depths

Author

Nunez, Johanna, primary, Levi, Benjamin, additional, Hong, Jonathan, additional, Carlson, Deborah, additional, Huebinger, Ryan, additional, Chan, Rodney, additional, Wan, Bingchun, additional, Mironov, Sergey, additional, Mandell, Samuel, additional, Goverman, Jeremy, additional, Akarichi, Chiaka, additional, Berenfeld, Omer, additional, Arnoldo, Brett, additional, and Clark, Audra, additional

Published
2023
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17. List of Contributors

Author

Ahuja, Rajeev B, primary, Aili Low, J F, additional, Arnoldo, Brett D., additional, Ayadi, Amina El, additional, Bache, Sarah E, additional, Barret, Juan P, additional, Barrow, Robert E, additional, Benjamin, Debra A, additional, Berger, Mette M, additional, Bernal, Eileen, additional, Bitz, Genevieve H, additional, Bohanon, Fredrick J, additional, Bojovic, Branko, additional, Branski, Ludwik, additional, Brownson, Elisha G, additional, Buffalo, Michael C, additional, Cambiaso-Daniel, Janos, additional, Campbell, Stephanie A, additional, Cancio, Leopoldo C, additional, Capek, Karel D, additional, Carmichael, Kelly D, additional, Carson, Joshua S, additional, Carter, Michele, additional, Celis, Mario M, additional, Chai, Jiake, additional, Chatterjee, Pallab, additional, Chilton, Linda, additional, Chung, Dai H, additional, Chung, Kevin K, additional, Clark, Audra T, additional, Cochran, Amalia, additional, Cowan, April, additional, Cox, Robert A, additional, Craft-Coffman, Beretta, additional, Culnan, Derek M, additional, Dannoun, Moayad, additional, Desmoulière, Alexis, additional, Donelan, Matthias B, additional, Dziewulski, Peter, additional, El-Muttardi, Naguib, additional, Enkhbaatar, Perenlei, additional, Fagan, Shawn P, additional, Fauerbach, James A, additional, Finnerty, Celeste C, additional, Gabriel, Christian, additional, Gallagher, James J, additional, Gibran, Nicole S, additional, Goodwin, Cleon W, additional, Goverman, Jeremy, additional, Guillory, Ashley N, additional, Haller, Herbert L, additional, Hassanpour, Houman K, additional, Hawkins, Hal K, additional, Herndon, David N, additional, Hollyoak, Maureen, additional, Huang, Ted T, additional, Hughes, Byron D, additional, Hundeshagen, Gabriel, additional, Ismail, Mohamed E., additional, Jaco, Mary, additional, Jeschke, Marc G, additional, Jimenez, Carlos, additional, Jokuszies, Andreas, additional, Kamolz, Lars-Peter, additional, Kemp-Offenberg, Jennifer, additional, Kinsky, Michael P, additional, Klein, Gordon L., additional, Kobayashi, Makiko, additional, Kramer, George C, additional, Kuhlmann-Capek, Maggie J, additional, Kwan, Peter, additional, Lee, Jong O, additional, Lee, Kwang Chear, additional, Leon-Villapalos, Jorge, additional, Levi, Benjamin, additional, Lineaweaver, William C, additional, Linticum, Kimberly M, additional, Lisiecki, Jeffrey, additional, Lopez, Omar Nunez, additional, Martinello, Caroline, additional, Martyn, J A Jeevendra, additional, Mason, Arthur D, additional, McLaughlin, Jillian M, additional, Merkley, Kevin H, additional, Meyer, Walter J, additional, Middelkoop, Esther, additional, Milner, Stephen M, additional, Mlcak, Ronald P, additional, Moiemen, Naiem S., additional, Morris, Stephen E, additional, Mozingo, David W, additional, Muller, Michael, additional, Mullins, Robert F, additional, Muthumalaiappan, Kuzhali, additional, Niederbichler, Andreas D, additional, Norbury, William B, additional, Ott, Sheila, additional, Peterlik, Christian, additional, Philp, Bruce, additional, Porter, Craig, additional, Pruitt, Basil A, additional, Radhakrishnan, Ravi S, additional, Rimmer, Ruth B, additional, Rosenberg, Laura, additional, Rosenberg, Marta, additional, Sanford, Arthur P, additional, Sarpong, Kwabena O, additional, Serghiou, Michael A, additional, Sheridan, Robert L, additional, Sherman, William C, additional, Sherwood, Edward R., additional, Smith, Lisa W, additional, Sousse, Linda E., additional, Spies, Marcus, additional, Suman, Oscar E, additional, Suzuki, Fujio, additional, Talon, Mark, additional, Thomas, Christopher R., additional, Toliver-Kinsky, Tracy, additional, Tredget, Edward E, additional, Trocmé, Stefan D, additional, Tropez-Arceneaux, Lisa L, additional, Vogt, Peter M, additional, Voigt, Charles D, additional, Voigt, David W, additional, Warden, Glen, additional, Wiechman, Shelley, additional, Willebrand, Mimmie, additional, Williams, Felicia N, additional, Williamson, Stephen, additional, Wolf, Steven E, additional, Woodson, Lee C., additional, Woodson, Sue M., additional, Wurzer, Paul, additional, Yngve, David, additional, and Zapata-Sirvent, Ramón L., additional

Published
2018
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19. Electrical injury

Author

Arnoldo, Brett D., Hunt, John L., Purdue, Gary F., Jeschke, Marc G., editor, Kamolz, Lars-Peter, editor, Sjöberg, Folke, editor, and Wolf, Steven E., editor

Published
2012
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20. Rural Burn Care

Author

Purdue, Gary F., Arnoldo, Brett D., Wichmann, Matthias, editor, Borgstrom, David C., editor, Caron, Nadine R., editor, and Maddern, Guy, editor

Published
2011
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21. Renal Replacement Therapy in Severe Burns: A Multicenter Observational Study

Author

Chung, Kevin K, Coates, Elsa C, Hickerson, William L, Arnold-Ross, Angela L, Caruso, Daniel M, Albrecht, Marlene, Arnoldo, Brett D, Howard, Christina, Johnson, Laura S, McLawhorn, Melissa M, Friedman, Bruce, Sprague, Amy M, Mosier, Michael J, Smith, David J, Jr., Karlnoski, Rachel A, Aden, James K, Mann-Salinas, Elizabeth A, Wolf, Steven E, King, Booker T, Rizzo, Julie A, Pamplin, Jeremy C, Driscoll, Ian R, Renz, Evan M, Lundy, Jonathan B, Mann-Salinas, Elizabeth, Cancio, Leopoldo C, Cruse, Carl W, McFarren, Christopher A, Brown, Kimberly S, Showkat, Arif, George, Lekha, Kumar, Aneel, Birmingham, Barbara, Hill, David, Bruce, Mary E, Sanford, Arthur P, Leehey, David J, Mullins, Robert F, Hassan, Zaheed, Shaver, Joseph R, Fosters, Kevin N, Peck, Michael D, Phelan, Herb A, and Saxena, Ramesh

Published
2018
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31. 533 Human Case Characterizations of Skin Burn Using Novel Multi-Spectral Short Wave Infrared Imaging

Author

Nunez, Johanna H, primary, Park, Caroline, additional, Clark, Audra, additional, Akarichi, Chiaka, additional, Arnoldo, Brett, additional, Mandell, Samuel P, additional, Carlson, Deborah L, additional, Huebinger, Ryan M, additional, Chan, Rodney K, additional, Goverman, Jeremy, additional, Mironov, Sergey, additional, Levi, Benjamin, additional, and Berenfeld, Omer, additional

Published
2022
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40. Electrical injuries

Author

Arnoldo, Brett D., primary, Hunt, John L., additional, Sterling, Jose P., additional, and Purdue, Gary F., additional

Published
2012
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42. List of Contributors

Author

Aarsland, Asle, primary, Aikawa, Naoki, additional, Al-Mousawi, Ahmed M, additional, Arnoldo, Brett D, additional, Barret, Juan P, additional, Barrow, Robert E., additional, Benjamin, Debra A, additional, Blakeney, Patricia E, additional, Børsheim, Elisabet, additional, Branski, Ludwik K., additional, Buffalo, Michael C, additional, Chai, Jiake, additional, Chen, Xin, additional, Chung, Dai H, additional, Chung, Kevin K, additional, Cochran, Amalia, additional, Colon, Nadja, additional, Cowan, April, additional, Demling, Robert H, additional, Desmoulière, Alexis, additional, Dibildox, Manuel, additional, Donelan, Matthias B, additional, Dziewulski, Peter, additional, Elijah, Itoro E, additional, Enkhbaatar, Perenlei, additional, Evans, E Burke, additional, Fagan, Shawn P, additional, Fauerbach, James A, additional, Feldman, Michael J, additional, Finnerty, Celeste C, additional, Gabriel, Christian, additional, Gallagher, James J, additional, Gamelli, Richard L, additional, Gauglitz, Gerd G, additional, Gibran, Nicole S, additional, Goodwin, Cleon W., additional, Goverman, Jeremy, additional, Graves, Caran, additional, Haller, Herbert L, additional, Hartford, Charles E, additional, Hawkins, Hal K, additional, Hegde, Sachin D, additional, Heimbach, David M, additional, Herndon, David N, additional, Hollyoak, Maureen, additional, Huang, Ted, additional, Hunt, John L, additional, Jaco, Mary, additional, Jeschke, Marc, additional, Jimenez, Carlos J, additional, Jokuszies, Andreas, additional, Kagan, Richard J, additional, Kamolz, Lars-Peter, additional, Kinsky, Michael P, additional, Klein, Gordon L, additional, Koch, Eric, additional, Kramer, George C, additional, Kwan, Peter, additional, Lawrence, John, additional, Lee, Jong O, additional, Leon-Villapalos, Jorge, additional, Lewis, Giavonni M, additional, Liao, Eric C, additional, Low, JF Aili, additional, Mason, Arthur D, additional, Maybauer, Dirk M, additional, Maybauer, Marc O, additional, McCauley, Robert L, additional, McEntire, Serina J, additional, Meyer, Walter John, additional, Milner, Stephen M, additional, Mlcak, Ronald P, additional, Morris, Stephen E, additional, Morvant, Elise M, additional, Mozingo, David W, additional, Muller, Michael, additional, Murphey, Erle D, additional, Muthu, Kuzhali, additional, Niederbichler, Andreas D, additional, Norbury, William B, additional, Nugent, Nora, additional, Ott, Sheila, additional, Pereira, Clifford, additional, Peterlik, Rudolf C, additional, Porro, Laura J, additional, Posluszny, Joseph A, additional, Pruitt, Basil A, additional, Purdue, Gary F., additional, Qin, Fengjun, additional, Robb, Edward C, additional, Rodriguez, Noe A, additional, Rosenberg, Laura, additional, Rosenberg, Lior, additional, Rosenberg, Marta, additional, Saffle, Jeffrey R, additional, Sakurai, Hiroyuki, additional, Sanford, Arthur P, additional, Sayeed, Syed M, additional, Schlegel, Cameron, additional, Serghiou, Michael A, additional, Shankar, Ravi, additional, Shen, Yuming, additional, Sheridan, Robert L, additional, Sherwood, Edward R, additional, Spies, Marcus, additional, Sterling, Jose P, additional, Suman, Oscar E, additional, Talon, Mark, additional, Thomas, Christopher R, additional, Toliver-Kinsky, Tracy, additional, Tompkins, Ronald G, additional, Traber, Daniel L, additional, Tredget, Edward E, additional, Tropez-Arceneaux, Lisa L, additional, Tropez-Sims, Susanne, additional, Villarreal, Cynthia G, additional, Vogt, Peter M, additional, Warden, Glenn D, additional, Warner, Petra M, additional, Whitehead, Christopher C, additional, Wiechman, Shelley A, additional, Willebrand, Mimmie, additional, Williams, Felicia N, additional, Williams-Bouyer, Natalie M, additional, Winter, Robert, additional, Wolf, Steven E, additional, Woodson, Lee C, additional, and Yang, Jui-Yung, additional

Published
2012
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46. Contributors

Author

Aarsland, Asle, primary, Arnoldo, Brett D., additional, Barret, Juan P., additional, Barrow, Robert E., additional, Beckum, Orlando K., additional, Beierle, Elizabeth A., additional, Bessey, Palmer Q., additional, Blakeney, Patricia E., additional, Buffalo, Michael C., additional, Chan, Edward Y., additional, Chung, Dai H., additional, Demling, Robert H., additional, Donelan, Matthias B., additional, Dougherty, William R., additional, Enkhbaatar, Perenlei, additional, Evans, E. Burke, additional, Fagan, Shawn P., additional, Farmer, Scott, additional, Fauerbach, James A., additional, Gahankari, Dilip, additional, Gallagher, James J., additional, Gamelli, Richard L., additional, Ghahary, Aziz, additional, Gibran, Nicole S., additional, Gibson, Pam, additional, Goodwin, Cleon W., additional, Gordon, Mary D., additional, Graves, Caran, additional, Greenhalgh, David G., additional, Hartford, C. Edward, additional, Hawkins, Hal H., additional, Heggers, John P., additional, Heimbach, David M., additional, Herndon, David N., additional, Hollyoak, Maureen, additional, Huang, Ted, additional, Hunt, John L., additional, Jaco, Mary, additional, Jeschke, Marc G., additional, Jones, Stephen B., additional, Kagan, Richard J., additional, Kealy, G. Patrick, additional, Kinsky, Michael P., additional, Klein, Gordon L., additional, Kramer, George C., additional, Lee, Jong O., additional, Linares, Hugo A., additional, Loran, David B., additional, Lund, Tjøstolv, additional, Lynch, James E., additional, McCauley, Robert L., additional, McQueen, K.A. Kelly, additional, Marvin, Janet, additional, Mason, Arthur D., additional, Maybauer, Dirk M., additional, Maybauer, Marc O., additional, Meyer, Walter J., additional, Milner, Stephen M., additional, Mlakar, Joseph M., additional, Mlcak, Ronald P., additional, Morgan, Dan, additional, Morris, Stephen E., additional, Morvant, Elise M., additional, Mozingo, David W., additional, Muehlberger, Thomas, additional, Muller, Michael, additional, Murphey, Erle D., additional, Muthu, Kuzhali, additional, Niederbichler, Andreas D., additional, Norbury, William B., additional, Nugent, Nora, additional, Ott, Sheila, additional, Patterson, David R., additional, Pereira, Clifford T., additional, Pham, Tam N., additional, Plessinger, Ronald T., additional, Pruitt, Basil A., additional, Przkora, Rene, additional, Purdue, Gary F., additional, Robb, Edward C., additional, Robert, Rhonda, additional, Rosenberg, Laura, additional, Rosenberg, Marta, additional, Saffle, Jeffrey R., additional, Sanford, Arthur P., additional, Scott, Paul G., additional, Serghiou, Michael A., additional, Shankar, Ravi, additional, Sheridan, Robert L., additional, Sherwood, Edward R., additional, Smith, Jason W., additional, Spies, Marcus, additional, Suman-Vejas, Oscar E., additional, Talon, Mark, additional, Thomas, Christopher R., additional, Toliver-Kinsky, Tracy, additional, Tompkins, Ronald G., additional, Traber, Daniel L., additional, Tredget, Edward E., additional, Villarreal, Cynthia, additional, Vogt, Peter M., additional, Wachtel, Thomas L., additional, Wang, JianFei, additional, Warden, Glenn D., additional, Warner, Petra M., additional, Williams-Bouyer, Natalie, additional, Wolf, Steven E., additional, Woodson, Lee C., additional, and Zwischenberger, Joseph B., additional

Published
2007
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48. Muscle Homeostasis Is Disrupted in Burned Adults

Author

Clark, Audra T, primary, Song, Juquan, additional, Yao, Xiao, additional, Carlson, Deborah, additional, Huebinger, Ryan M, additional, Mei Liu, Ming, additional, Madni, Tarik D, additional, Imran, Jonathan B, additional, Taveras, Luis R, additional, Weis, Holly B, additional, Arnoldo, Brett D, additional, Phelan, Herb A, additional, and Wolf, Steven E, additional

Published
2019
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