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Management of Concomitant Severe Thermal Injury and ST-Elevation Myocardial Infarction
- Source :
- European Burn Journal, Vol 5, Iss 2, Pp 169-174 (2024)
- Publication Year :
- 2024
- Publisher :
- MDPI AG, 2024.
-
Abstract
- Acute coronary thrombosis is a known, but rare, contributor to morbidity and mortality in patients with thermal and electrical injuries. The overall incidence of myocardial infarction among burn patients is 1%, with an in-hospital post-infarction mortality of approximately 67%, whereas the overall mortality rate of the general burn patient population is from 1.4% to 18%. As such, early detection and effective peri-operative management are essential to optimize patient outcomes. Here, we report the details of the management of an adult male patient with a 65% total body surface area severe thermal injury, who developed an ST-elevation myocardial infarction (STEMI) in the resuscitation period. The patient was found to have 100% occlusion of his left anterior descending coronary artery, for which prompt coronary artery stent placement with a drug-eluting stent (DES) was performed. Following stent placement, the patient required dual antiplatelet therapy. The ongoing dual antiplatelet therapy required the development of a detailed peri-operative protocol involving pooled platelets, packed red blood cells, desmopressin (DDAVP™) and intraoperative monitoring of the patient’s coagulation parameters with thromboelastography for three staged operative interventions to achieve complete debridement and skin grafting of his burn wounds.
Details
- Language :
- English
- ISSN :
- 26731991
- Volume :
- 5
- Issue :
- 2
- Database :
- Directory of Open Access Journals
- Journal :
- European Burn Journal
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.38271b7f770469ab935f7422b7fff5a
- Document Type :
- article
- Full Text :
- https://doi.org/10.3390/ebj5020015