Burns : journal of the International Society for Burn Injuries
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Plasma atrial natriuretic peptide levels (proANP (1-98)), a parameter of myocardial dysfunction, have been reported to be increased in critically ill patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS). The aim of the study was to examine if proANP is a biomarker of ALI/ARDS as assessed by the Sequential Organ Failure Assessment score (SOFA Lung ≥2) in burn patients, and how it compares to the corresponding values for age, total body surface area percent (TBSA%) and inhalation injury for mortality prediction. ⋯ ProANP levels, as a biomarker of ALI/ARDS, in critically burn patients correlated with SOFA scoring. The inhalation injury did not lead to increase in proANP values.
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This study was done to determine the severity of symptoms of depression in burned patients and to assess the effect of burn related factors on depression. ⋯ The high prevalence of symptoms of depression in burned patients suggests that depression should be screened in such patients and treat if indicated.
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Cell banked epidermal skin progenitor cells have the potential to provide an "off-the-freezer" product. Such cells may provide a skin donor area-independent cell-spray grafting therapy for the treatment of burns. We first characterized fetal skin samples of gestational ages ranging from 6 to 21 weeks. As the results suggest that the phenotypic differentiation occurs after 10 weeks, which may complicate follow-up in vitro studies, we developed and compared different cell isolation techniques for human fetal skin-derived epithelial cells from tissue ages 6 to 9 weeks. We initially screened seven methods of characterization, concluding that two methods warranted further investigation: incubating the epidermal tissue in Petri-dishes with culture medium for spontaneous cell outgrowth, and wiping the epidermal tissue onto a dry Petri-dish culture surface followed by adding culture medium. Non-controllable culture contamination with dermal cells was the reason for excluding the other five methods. The results suggest that epidermal cells can be isolated from tissue exhibiting a single homogeneous layer of CK15(+) basal keratinocytes up to week 9. At later gestational ages, the ongoing skin differentiation results in a multi-layer basal structure and progenitors associated with the hair bulb would have to be considered. Spraying the resulting cells with a clinical spray device was successfully demonstrated in an in vitro model. ⋯ Gestational age 6-9 weeks epidermal human fetal skin cells from the basal layer can be reproducibly isolated and transferred into culture for studies on the development of skin cell transplantation therapies.
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Swine are the preferred animal models to study the effects of burns on dermal wound healing. Various studies have been published in which little emphasis was placed on minimizing burn variability and inconsistency. We developed a novel method to create deep partial thickness burns that are highly consistent. ⋯ Digital image analysis showed inconsistent healing in burns created using boiling water as compared to the boiling PEG:H(2)O solution. Additionally, histological analyses showed that burns created using boiling water were superficial and more variable compared to those created using the boiling PEG:H(2)O solution. With a burn contact time of 20 s, 48.5±5.7% tissue damage was demonstrated at 24 h when the PEG:H(2)O solution was used, whereas only 11.9±1.3% was observed with boiling water.
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The purpose of this study was to assess the usefulness of stroke volume variations to monitor the early fluid resuscitation in mechanically ventilated burn ICU patients. ⋯ Our results suggest that measurement of stroke volume variations by arterial pulse contour analysis is valuable in monitoring volume administration and in predicting volume responsiveness during the early postburn period.