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Adequate fluid therapy is crucial to maintain organ function after burn trauma. Major burns lead to a systemic response with fluid loss and cardiac dysfunction. To guide fluid therapy, measurement of cardiac pre- and afterload is helpful. Whereas cardiac function is usually measured after admission to intensive care unit (ICU), in this study, hemodynamic monitoring was performed directly after arrival at hospital. We conducted a prospective cohort study with inclusion of 19 patients (male/female 13/6, 55 ± 18 years, mean total body surface area 36 ± 19%). Arterial waveform analysis (PulsioFlexProAqt®, Getinge) was implemented immediately after admission to hospital to measure cardiac pre- and afterload and to guide resuscitation therapy. Cardiac parameters 3.75 (2.67-6.0) h after trauma were normal regarding cardiac index (3.45 ± 0.82) L/min/m², systemic vascular resistance index (1749 ± 533) dyn sec/cm5 m2, and stroke volume (SV; 80 ± 20) mL. Stroke volume variation (SVV) was increased (21 ± 7) % and associated with mortality (mean SVV survivors vs nonsurvivors 18.92 (±6.37) % vs 27.6 (±5.68) %, P =.017). Stroke volume was associated with mortality at the time of ICU-admission (mean SV survivors vs nonsurvivors 90 (±20) mL vs 50 (±0) mL, P =.004). Changes after volume challenge were significant for SVV (24 ± 9 vs19 ± 8%, P =.01) and SV (68 ± 24 vs 76 ± 26 mL, P =.03). We described association of SVV and SV with survival of severely burned patients in an observational study. This indicates high valence of those parameters in the early postburn period. The use of an autocalibrated device enables a very early monitoring of parameters relevant to burn shock survival. [ABSTRACT FROM AUTHOR]

The contribution of endothelial injury to the pathogenesis of burn shock is not well characterized. This work investigates potential mechanisms underlying dysregulation of endothelial barrier function by burn patient plasmas. Plasma was collected from burn-injured patients (n = 8) within 4 h of admission. Demographic and injury characteristics were collected and markers of injury severity including international normalized ratio, activated partial thromboplastin time, and levels of syndecan-1 and interleukin (IL)-6, IL-1B, IL-10, Il-12p70, and tumor necrosis factor-α measured. Human umbilical vein endothelial cell monolayers (HUVEC-m) exposed to either burn patient plasma or multidonor plasma (HHP) were assessed for permeability (40 kDa fluorescein isothiocyanate (FITC)-Dextran diffusion), intercellular gap area (F-actin staining) and incidence of apoptosis (TUNEL assay). Post plasma exposure, RNA was isolated and used in polymerase chain reaction (PCR) arrays targeting genes relevant to cytoskeletal structure or apoptosis. Differences between HHP and burn plasma-treated HUVEC-m were analyzed. Five plasmas promoted significant increases in HUVEC-m permeability. When plasmas were grouped based on their capacity to increase permeability, no differences in age, %total body surface area, gender, hospital mortality, international normalized ratio, activated partial thromboplastin time, or cytokine concentration were observed; however, significantly higher syndecan-1 levels were seen in the plasmas inducing increased permeability. Increases in intercellular gap area and apoptosis and relevant gene expression were observed after exposure to patient plasmas but none of these metrics correlated completely with the pattern or magnitude of the changes in permeability. Burn patient plasmas variably disrupt HUVEC-m homeostasis, differentially inducing changes in permeability, intercellular gap area, and apoptosis. Neither increases in intercellular gap size nor apoptosis appear sufficient to explain the pattern of changes in permeability. [ABSTRACT FROM AUTHOR]

Plasma inclusive resuscitation (PIR) uses fresh frozen plasma as an adjunct to crystalloid in the management of burn shock and has potential benefits over other colloids. Yet, safety concerns for transfusion-related acute lung injury (TRALI) exist. The aim of this study evaluated the association between TRALI and PIR in a cohort of severely burn-injured patients using the updated Canadian Blood Services Consensus definitions. Burn-injured patients requiring PIR at a burn center from 2018 to 2022 were retrospectively reviewed. To assess for TRALI, data related to acute hypoxemia, bilateral pulmonary edema, left atrial hypertension, and changes to respiratory status up to 6 h after PIR were recorded. To identify other risks and benefits associated with PIR timing, resuscitative volumes and outcomes were compared between early (0-8 h) and late PIR (8-24 h) initiation. Of the 88 patients included for study, no patient developed TRALI type I or II under the updated definitions. Early (n = 39) compared to late PIR (n = 49) was associated with a higher percent total body surface area (TBSA, 36.3%, 26.0%, P = 0.01). The predicted 24-h volume was higher for early PIR (10.1 L, 6.3 L, P = 0.049), but the observed 24-h volume (cc/kg/%TBSA) was not significantly different (5.2, 5.3, P = 0.62). In a cohort of severely burn-injured patients undergoing PIR, no patient developed TRALI type I or type II under the updated Canadian Blood Services Consensus definitions. Earlier use of PIR was not associated with higher resuscitative volumes despite higher TBSA. Further studies are necessary to better ascertain the potential risks and benefits associated with PIR. [ABSTRACT FROM AUTHOR]

After a burn, plasma like fluid rapidly leaks into tissue gaps and skin lesions, leading to a sharp decrease in effective circulating blood volume and the patient entering the shock phase. At this time, the primary treatment measure is to implement rapid and efficient fluid resuscitation. On the basis of using the formula for fluid resuscitation, effective individualized resuscitation is carried out. The core issue of fluid resuscitation in burn patients during the shock phase is to select appropriate monitoring indicators to evaluate the resuscitation effect, guide the resuscitation process, and avoid ineffective or excessive resuscitation. This article summarizes existing literature and reference materials to discuss the application progress of various invasive monitoring indicators that have reference value for guiding fluid resuscitation and evaluating the effectiveness of resuscitation in burn patients during the shock phase fluid resuscitation process, providing reference for the diagnosis and treatment process of burn patients during shock phase fluid resuscitation. [ABSTRACT FROM AUTHOR]

Background: After hypovolemic shock caused by severe burns, lipid peroxidation is an important factor in tissue edema and multiorgan dysfunction syndrome (MODS). Many studies have shown that valproic acid (VPA) inhibits lipid peroxidation and reduces tissue and organ injury. Objectives: This study investigated whether the VPA treatment of scalded rats reduced tissue edema by inhibiting lipid peroxidation, thereby improving organ function and survival rate. Materials and Methods: A total of 60 male Sprague-Dawley rats (weighing: 280–300 g) with a 50% total body surface area (TBSA) full-thickness dermal burn were randomly assigned to the following 3 groups (with 20 rats per group): (I) the no infusion resuscitation (NR) group; (II) the sodium lactate Ringer's solution (LR) group; and (III) the sodium valproate Ringer's solution (VR) group. After scalding, the following hemodynamic parameters were measured: Copper2+-Zinc2+-superoxide dismutase (Cu2+-Zn2+-SOD) activity, thiobarbituric acid reactive substances (TBARSs), oxidized glutathione (GSSG), reduced glutathione (GSH), and antioxidant enzyme activities. Organ function parameters and water content were also measured. Another 60 male Sprague-Dawley rats were used to observe the 24-h survival rate of the rats using the same scald model and fluid resuscitation. Results: VPA significantly increased the mean arterial pressure (MAP) and cardiac output (CO), and significantly decreased the pulmonary vascular permeability index (PVPI) and extravascular lung water index (ELWI). VPA also increased plasma Cu2+-Zn2+-SOD activity and decreased the plasma TBARS level. VPA reduced the TBARS level and GSSG in various tissues and increased the concentration of GSH. VPA decreased glutathione peroxidase (GPx) and catalase (CAT) activity, but significantly increased glutathione reductase (GR) activity in various tissues. VPA significantly improved organ functions and decreased water content. VPA significantly improved the survival rate, and the 24-h survival rate of the VR group was double that of the LR group. Conclusion: Resuscitation with VPA reduced tissue edema, protected visceral functions, and improved the survival rate of rats with severe burn shock (BS) by alleviating lipid peroxidation. [ABSTRACT FROM AUTHOR]

The evaluation of informative significance of homeostasis disturbance by degree of severity was carried out, and then the development of prognostic algorithms and verification of their effectiveness. It should be noted that all patients had deep burns from 10% to 45% of the body surface. Exactly these victims made up the basic array with the help of which the tasks on estimation of information significance and development of prognostic algorithm were solved. Adequate preoperative measures allowed to improve both the indices of the circulatory system and the clotting system in patients with mild and medium degree of plasmoporia. [ABSTRACT FROM AUTHOR]

Objective: Burn shock is a serious complication that presents with profound cardiovascular suppression that may require vasopressor support for hemodynamic stability. This study aims to explore the patterns of systemic Norepinephrine use and skin graft take in patients with deep burns requiring excision and grafting. Methods: Burn patients ages 18–89 years that presented to our regional burn center from January 2014–June 2020 and were treated with systemic vasopressors within the first 48 h of admission, and received at least one tangential excision and split thickness skin graft (STSG) procedure as part of their treatment were retrospectively identified. Patients receiving vasopressors were compared to a matched cohort of patients not receiving vasopressors yet with similar demographics, burn trauma, and smoke inhalation injury. Major outcomes investigated included: average overall graft take, amount of Norepinephrine received, total amount of fluids used for resuscitation, number of operations, and length of hospital stay. Results: The mean graft uptake for patients treated with systemic Norepinephrine (80.0%) was significantly lower than the mean graft uptake for patients not treated with systemic Norepinephrine (91.4%, p

Burns are injuries to the skin or other organic tissues that are caused by the local action of high temperatures. The cause of burns can be: flame/explosion, hot liquids or gases, superheated or incandescent solids, electric current, chemicals agents and sunlight. There are 4 degrees of burns, depending on the intensity of the burn and its morphological aspects. The "palm area", conventionally equal to 1% of the body surface and the "rule of 9", are used to estimate the burned body surface. There are different scores to determine the severity and prognosis of burns, so: Baux, ABSI. In the forensic diagnosis it is necessary to determine when the burn occurred - during life or after death (antemortem or postmortem burns). [ABSTRACT FROM AUTHOR]

Severe burn injury poses significant clinical challenges, often necessitating the use of vasoactive agents to maintain perfusion. This narrative review explores the current landscape of vasoactive agents in acute burn shock resuscitation and severe burn-injured patients who develop septic shock, with a particular focus on the potential role of the novel vasoactive agent, synthetic angiotensin-II (AT-II), in these settings. While catecholamines and vasopressin remain cornerstone therapies, adverse effects, variable patient response, and a new understanding of burn injury pathophysiology highlight the potentially evolving role of vasoactive agents in these clinical scenarios. A key system involved in blood pressure regulation, the renin-angiotensin-aldosterone system (RAAS), is often dysregulated in acute burn and septic shock. Contributory mechanisms and potential benefits of synthetic AT-II are discussed here within and form the physiologic rationale behind exogenous administration of synthetic AT-II in the context of available safety and efficacy data. To date, administration of synthetic AT-II administration has shown promise in improving hemodynamics and clinical outcomes in distributive shock populations; however, data in acute burn shock and burn patients who develop septic shock are lacking. In addition, a comprehensive understanding of the potential and future areas of research in burn shock and severe burn-injured patients is provided., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association.)

Burn injury is an important medical problem, as it is accompanied by high mortality rates in burn shock. Aim of the study was to conduct an ultrastructural stereological analysis of changes in the blood microvessels of the left ventricular myocardium in burn shock.Material and methods. Myocardial samples during the early section were collected 2 hours after the detection of biological death in the victims from severe burn shock (3 men and 2 women); age group 32-44 years. An ultrastructural study of endothelial cells of the microvasculature of the left ventricular myocardium was carried out.Results and discussion. The development of severe burn shock is accompanied by changes in the ultrastructure of the endothelial cells of the blood microvessels of the left ventricular myocardium, which is associated with intracellular degradation and exocytosis. These ultrastructural changes may indicate impairment of vesicular transport in the endothelium of the myocardial microvessels in burn shock. A feature of the ultrastructure of the endothelium was the heterogeneity of the endothelial cells of the blood capillaries due to the revealed dark and light endothelial cells, which differ in the saturation of the cytoplasm with organelles. The new data obtained on changes in the ultrastructure of the endothelium of the microvasculature of the left ventricular myocardium can be informative in the development of approaches to intensive therapy of cardioprotective direction in combustiological patients with burn shock.

Burns are one of the most common causes of home injuries, characterized by serious damage to the skin and causing the death of affected tissues. In this review, we intended to collect information on the pathophysiological effects of burns in pediatric patients, with particular emphasis on local and systemic responses. A total of 92 articles were included in the review, and the time range of the searched articles was from 2000 to 2021. The occurrence of thermal injuries is a problem that requires special attention in pediatric patients who are still developing. Their exposure to various burns may cause disturbances in the immune response, not only in the area of tissue damage itself but also by disrupting the systemic immune response. The aspect of immunological mechanisms in burns requires further research, and in particular, it is important to focus on younger patients as the existence of subtle differences in wound healing between adults and children may significantly influence the treatment of pediatric patients. [ABSTRACT FROM AUTHOR]

Xiao Fang,* Shu-Fang Duan,* Yu-Zhou Gong,* Fei Wang, Xu-Lin Chen Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xu-Lin ChenDepartment of Burns, The First Affiliated Hospital of Anhui Medical University, 120 Wanshui Road, Hefei, Anhui 230088, People’s Republic of ChinaTel/Fax +86-551-65908495Email okcxl@126.comBackground: Patients with severe burns continue to display a high mortality rate during the initial shock period. The precise molecular mechanism underlying the change in host response during severe burn shock remains unknown. This study aimed to identify key genes leading to the change in host response during burn shock.Methods: The GSE77791 dataset, which was utilized in a previous study that compared hydrocortisone administration to placebo (NaCl 0.9%) in the inflammatory reaction of severe burn shock, was downloaded from the Gene Expression Omnibus (GEO) database and analyzed to identify the differentially expressed genes (DEGs). Functional enrichment analyses of Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were performed. The protein–protein interaction (PPI) network of DEGs was constructed using the Search Tool for the Retrieval of Interacting Genes (STRING) database and then visualized in Cytoscape. In addition, important modules in this network were selected using the Molecular Complex Detection (MCODE) algorithm, and hub genes were identified in cytoHubba, a Cytoscape plugin.Results: A total of 1059 DEGs (508 downregulated genes and 551 upregulated genes) were identified from the dataset. The DEGs enriched in GO terms and KEGG pathways were related to immune response. The PPI network contained 439 nodes and 2430 protein pairs. Finally, important modules and hub genes were identified using the different Cytoscape plugins. The key genes in burn shock were identified as arginase 1 (ARG1), cytoskeleton-associated protein (CKAP4), complement C3a receptor (C3AR1), neutrophil elastase (ELANE), gamma-glutamyl hydrolase (GGH), orosomucoid (ORM1), and quiescin sulfhydryl (QSOX1).Conclusion: The DEGs, functional terms and pathways, and hub genes identified in the present study can help shed light on the molecular mechanism underlying the changes in host response during burn shock and provide potential targets for early detection and treatment of burn shock.Keywords: burn shock, in silico study, host response, immune response

Modern treatment of burns has led to a significant reduction in mortality in patients with burns whose injuries were fatal several years ago. However, along with improved survival, new problems arose in the treatment of burn patients. Systemic inflammatory response, capillary leak, sepsis top the list of the most common problems in both adults and children with severe thermal injury. Currently, new strategies are being developed and studied in the treatment of this category of patients. One of the ways to improve the results of treatment of patients with severe burn injury is to prescribe corticosteroids, both in the stage of burn shock and in the development of septic complications. Do corticosteroids reduce mortality and improve recovery in burn patients? The discussion about this has been going on for many years, but the opinion about their effectiveness remains controversial. An analysis of the literature shows that corticosteroids can play a significant role in the treatment of patients with severe burn injury and can be successfully used at any stage of a burn disease. The effect of reducing capillary leakage, increasing myocardial contractility, antiemetic, membrane-stabilizing effect of corticosteroids will be useful in the stage of burn shock. The anti-inflammatory, immunomodulatory effect of corticosteroids will play a role in any stage of a burn disease. With the aim of preventing and treating sepsis, corticosteroids may be useful in the stage of toxemia, septicotoxemia. It is also necessary to remember about adrenal insufficiency, which develops in burn patients. The article analyzes the literature, substantiates the use of corticosteroids in patients with severe burn injury in different periods of a burn disease

Burns are the fourth most common type of trauma worldwide, with over 95 per cent of deaths attributed to burns occurring in lowto middle-income countries.¹ Anaesthetists are involved in the full spectrum of care for burn patients, from the initial resuscitation post injury through to reconstructive surgery and management of chronic pain that may result. The World Health Organization (WHO) defines a burn as "an injury to the skin or other organic tissue primarily caused by heat or due to radiation, radioactivity, electricity, friction or contact with chemicals".² Burns are classified according to severity through an assessment of depth, width and regions involved.³ Significant burns result in distinct local pathophysiological changes, which then result in a systemic response that affects all major organ systems in the body. The effect of burns on the cardiovascular system results in a distinct form of shock -- burn shock.³ The treatment for this is appropriately managed fluid resuscitation, especially within the initial 24 hours post injury. Fluid resuscitation that maintains tissue perfusion without being excessive has a survival benefit.³ There is currently no robust data that dictates the type, amount or timing of the fluid used or the ideal endpoints of resuscitation.4 Patients with major burns should be managed in specialised burn centres under the care of experienced clinicians for the best possible outcomes. [ABSTRACT FROM AUTHOR]

Background. We discussed main issues regarding pathogenesis of burn disease and development of multi-organ failure and identified basic methods for prevention and improvement.Objectives. We studied possible prevention of multi-organ failure syndrome.Material and methods. We presented analysis of treatment in hard-burnt patients for 10 years. This analysis included 643 compromised patients with deep burns. They were treated in Samarkand Branch of RNTEMP from 2008 to 2018, age range was 18–74 years. All patients were divided into 2 groups regarding their treatment method. Control group included 313 (48.67%) patients treated in Burn Department of Samarkand Branch of RNTEMP for the period 2008–2012.Their complex treatment included routine anti-shock infusion-transfusion therapy and conventional management regarding burn disease stages. Main group consisted of 330 (51.33%) patients with the same pathology referred to Samarkand Branch of RNTEMP during the period 2013–2018. They were treated with improved procedure of anti-shock infusion-transfusion therapy with inotropic and organo-saving support according to disorders of vital functions and early active surgical technique.Results. It is shown that implementation of advanced complex intensive infusion-transfusion therapy, application of organ-saving therapy, correction of the compromised premorbid background, and nutritional support as well facilitate shock manifestation, reduce number of patients with multi-organ insufficiency and mortality in hard-burnt cohort.

Background; Some studies have supported the opinion that patients who get greater volumes of resuscitation fluids are at a higher chance of edema, complications, and probably bad outcomes. In the results of the International Society of Burn Injuries approximately half (49.5%) added colloid before 24h. This study aims to analyze the relative risk for mortality comparing resuscitation in the first 24 hours with Parkland and resuscitation with the use of Colloids. Material and Methods; This was an observational prospective cohort study conducted in the Service of Burns of the University Hospital Centre "Mother Teresa" in Tirana (UHCT), Albania. The study includes adult patients with critical burns > 40% TBSA, hospitalized in the Intensive Care Unit of the service during the period 2014 to 2019. Resuscitation in the first 24 hours is done with Ringer Lactate according to Parkland and with Ringer Lactate with the addition of colloids after 12 hours. Results; The data for organ dysfunction and organ insufficiency were the same in the two groups without statistical significance. Mortality in the RL group was 48% (24 deaths of 50 patients) while in the RL + Colloid rehydrated group was 46% (23 deaths of 50 patients). Patients which have 40-60% burns and are rehydrated with RL + Colloids have a risk of death 0.4 times less than those rehydrated with RL. Conclusions; Resuscitation with Ringer lactate and Colloids in the first 24 hours of thermal damage is a rehydration alternative for the treatment of burn shock. This therapy especially helps patients with major burns > 40% TBSA who during rehydration require large amounts of fluids and are associated with severe plasma hypoalbuminemia. Number Need to Treat (NNT benefit) is 10 so 1 in 10 patients can benefit in lowering the risk of death with RL + Colloid rehydration.

The retrospective cohort comparative study was conducted in order to evaluate efficiency and safety of using 6% hydroxyethyl starch (HES) 130/0.4 for managing burn shock. The enrollment criteria were as follows: men and women above 18 years old, thermal burns from 20 to 80% of the body surface, the need of infusion therapy, expected duration of the patient’s stay in the intensive care department for more than 3 days, the absence of acute renal failure at the moment of hospital admission. All patients were divided into two groups. The 1st group (HES+) included 24 patients who received infusion therapy for 3 days with Ringer’s solution and 6% HES 130/0.4 additionally, the 2nd group (HES-) included 25 patients who were treated only with Ringer’s solution. Hospital mortality in the group (HES+) made 45.8% (11 patients died), and in the group (HES-) it made 28.0% (7 patients died), p = 0.3182. The extended surface of lesion was the independent factor of acute renal failure development in those suffering from severe burn injury: OR = 1.09 (1.01–1.19), p = 0.04; Baux OR greater index = 1.09 (1.01–1.19), p = 0.02 and the need in catecholamines – OR = 12.7 (1.2–144.9), p = 0.04. The study showed no confident difference in the frequency of acute renal failure, in the need of substitution renal therapy and mortality in two groups of patients receiving and not receiving HES. Using HES solutions in doses not exceeding the recommended ones did not facilitated the reduction of infusion therapy volume.

Acute burn injury creates a complex and multifactorial local response which may have systemic sequelae such as hypovolemia, hypothermia, cardiovascular collapse, hypercoagulability, and multi-system organ failure. Understanding the underlying pathophysiology of burn shock, the initial burn triage and assessment, calculation of fluid requirements, and the means of tailoring ongoing interventions to optimize resuscitation are critical for overcoming the wide spectrum of derangements which this condition creates. As a result, this article discusses the various key points in order to garner a greater understanding of these nuances and the optimal pathway to take when tackling these challenging issues., Competing Interests: Disclosure The authors have no relevant financial or conflict of interest disclosures to make as it relates to the topic of this article., (Copyright © 2023 Elsevier Inc. All rights reserved.)

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Purpose: to study and prove purpose of medical physical culture at extensive superficial burns of the I–II degree for normalization of exchange processes, the prevention of the developments of stagnation connected with the compelled decrease in physical activity. Materials and Methods: analysis and generalization of scientific and methodical literature. Results: the main means of physical rehabilitation – medical physical culture is considered; its application at treatment of patients with extensive superficial burns of the I–II degree is proved; techniques of medical physical culture in the period of little burn shock and in the period of a sharp toksemy are described in detail. Conclusions: it is established that occupation duration remedial gymnastics depends on a condition of the patient and objectives. In each occupation the all-strengthening, breathing and special exercises, as a rule, have to be applied. The most important feature of a technique of occupations at a burn disease is need of repeated performance during the day of the special exercises directed on prevention or elimination of malfunction of the musculoskeletal device

The article studied an influence of operative treatment on miners in the stage of burn shock, complicated by multi- and combined trauma and how these treatment options have changed the lethality and burn complications rates. All data based on an analysis of retrospective research. A primary surgical treatment of burn wounds was performed using simultaneous grafting by temporary biological cover for superficial burns during the burn shock stage in the main group of patients. For miners of comparison group this strategy hasn’t been applied and they were operated after ending of burn shock. The rate of development of burn sepsis decreased in 3,2 times (p=0,0001), the frequency of pneumonia reduced in 2,91 times (p=0,0001) and toxic encephalopathy - in 1,7 times (p=0,004) in the main group in relation to the comparison group. The authors made a conclusion, that significant reduction of the rate of the most dangerous complications of burns allowed decrease of lethality in patients of main group in 2,6 times in relation to the comparison group. There wasn’t carried out the primary surgical treatment of burns with covering of postoperative wound surfaces by temporary biological material during burn shock stage in comparison group.

High dose ascorbic acid (HDAA) has been touted to ameliorate inflammation and reduce fluid requirements during burn shock resuscitation (BSR). Whether this leads to improved outcomes is not known. The authors' aim for this study was to compare ventilator days, ventilator-associated pneumonia, and mortality between patients who did and did not receive HDAA during BSR.The authors performed a retrospective case control study from 2012 to 2015. They identified 38 patients (HDAA) who received HDAA during BSR. Using age and %TBSA, the authors identified and matched 42 control patients (CTL) who did not receive HDAA for BSR during that same time period. The authors collected data for age, %TBSA, hospital days (LOS), ventilator days (VENT), inhalation injury (INH), ventilator-associated pneumonia (VAP), and mortality (MORT).There were no differences in age and %TBSA or %TBSA of third-degree burn injury between groups. There was no significant difference in the incidence of INH (HDAA-52% vs CTL-36%, P = .17) and the groups had similar LOS and VENT. Additionally, there was no significant difference in VAP incidence (HDAA-29% vs CTL-14%, P = .13) or mortality (HDAA-26% vs CTL-23%, P = .8). HDAA patients had a numerically higher incidence of acute renal failure requiring dialysis (23 vs 7%, P = .06) which was confirmed in a multivariate analysis (odds ratio 5.4; 95% confidence interval 1.1-26). HDAA, while potentially reducing inflammation and fluid requirements during BSR, may not improve any meaningful outcomes such as ventilator requirements, ventilator-associated pneumonia, and mortality. [ABSTRACT FROM AUTHOR]

Nursing procedures in burn care have not been widely reviewed in Polish literature. Few studies relate procedures in emergency care and treatment of minor thermal burns. This paper presents nursing procedures in early treatment of burns, performed within the first 1-2 days from injury. The aim of this study was to present and discuss procedures of fluid resuscitation monitoring in burn shock in terms of nursing procedures. Experience in burn care (in burn shock therapy) was based on material of the patients treated at the East Centre of Burns Treatment and Reconstructive Surgery in 2009-2017. Data from recent and trust-worthy publications was also used. Nursing procedures in fluid resuscitation monitoring of patients with burn shock were created according to EBP guidelines and several studies from other countries. These procedures can be successfully applied in Poland. Fluid resuscitation monitoring procedures, which were presented in this paper, were an effective means of expressing and tracking fluid requirements which allows subsequent surgery. [ABSTRACT FROM AUTHOR]

It is a widely accepted fact that severe fluid loss is the greatest problem faced following major burn injuries. Therefore, effective fluid resuscitation is one of the cornerstones of modern burn treatment. The aim of this article is to review the current approaches available for modern trends in fluid management for major burn patients. As these current approaches are based on various experiences all over the world, the knowledge is essential to improve the status of this patient group.

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