Burns : journal of the International Society for Burn Injuries
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It is well recognised that initial estimates of the area involved in a burn injury by inexperienced clinicians are frequently excessive. In Britain the palmar surface area of the hand is taught to approximate 1% of the total body surface area (TBSA), but no allowance is made for variations in individual body weight. ⋯ This effect was, however, more pronounced in women, particularly those with a BMI greater than 31 kg/m(2) in whom the HSA represented only 0.64%. Awareness of the potential for over-estimation of burn surface area using this method alone may improve the accuracy of burn area estimation and consequent need for commencing resuscitation.
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Pulmonary failure remains the major determinant of mortality and morbidity following burn injury. We hypothesized that intratracheal instillation of perfluorocarbon liquids could be a therapeutic measure in combination with conventional mechanical ventilation to improve pulmonary gas exchange in acute respiratory distress syndrome with thermal injury. Forty-five New Zealand rabbits were used for this prospective and randomized experimental study. ⋯ In pulmonary parameters we observed significant (P<0.05) decrease in mean airway pressures from the pre-treatment value of 11.44+/-0.15 cm H(2)O to the post treatment 10.22+/-0.12 cm H(2)O and increase (P<0.05) in respiratory system compliance from 1.8+/-0.02 to 2.46+/-0.07 ml/cm H(2)O with the perfluorocarbon. Perfluorocarbon instillation did not result in statistically significant changes in arterial pressure, heart rate and central venous pressure. In conclusion, partial liquid ventilation with perfluorocarbon is a new technique leading to a marked and sustained improvement in oxygenation and pulmonary function in an experimental model of ARDS in burns.