Burns : journal of the International Society for Burn Injuries
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Despite advances in critical care and the surgical management of major burns, highly moribund patients are unlikely to survive. Little is known regarding the utilization and effects of palliative care services in this population. ⋯ 7424 major burns were included; 1.9% received palliative care services. Patients receiving palliation had a mean age of 63.6 years (SD 19.6), mean total body surface area of 62.2% (SD 24.9%), and mean modified Baux score of 127.1 (SD 26.7). Adjusting for covariates, the incidence rate ratio was 1.42 over the 10-year period (95% CI, 1.31-1.54, p<0.001). Independent predictors of palliative consultations included older age, larger burns, deeper burns, and higher Elixhauser comorbidity score. Among patients with modified Baux scores between 100-153, those receiving palliative care services were significantly more likely to die without surgery, OR 3.24 (95% CI 1.13-10.39, p=0.029), with no significant difference in mortality, OR 11.72 (95% CI 0.87-22.57, p=0.051) CONCLUSION AND RELEVANCE: Palliative care services were increasingly used during the study period. Palliative care services in highly moribund burn patients do not impact survival and may decrease the likelihood of surgical intervention in select patients.
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Electric burn patients usually suffer permanent injury and sequelae. Salvage of the zone of stasis is an important topic in the treatment of burn patients. N-Acetylcysteine (NAC), as an antioxidant, has effect on the saving zone of stasis and extensive rhabdomyolisis. The aim of this study was therefore to evaluate the effect of oral NAC on tissue destruction indicators in an electric burn rat model. ⋯ A decrease in electric burn necrotic area and tissue damage in the group using NAC treatment was demonstrated. NAC might have a beneficial effect in the treatment of electrical burns. Further experimental and clinical studies with NAC treatment are necessary to confirm these results.