Burns : journal of the International Society for Burn Injuries
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Volume resuscitation is often required in critically ill patients. However, we have no clear consensus on the choice between crystalloid solution and colloidal solution. This study aimed to explore the effect of albumin administration in massive fluid resuscitation. ⋯ Administration of albumin within 24 h after the initiation of crystalloids was associated with a lower mortality and a longer restricted mean survival time during 28-day follow-up and 60-day follow-up compared with crystalloid infusion alone. However, administration of albumin 24 h after the initiation of crystalloids was not associated with better prognosis compared to crystalloid infusion alone.
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Studies suggest increased occurrence of cancer in persons who have experienced a burn injury with hospital admission. ⋯ Patients that suffer burn injury have a higher incidence of cancer than the general population and a group matched by age, sex and degree of deprivation. A higher incidence of adverse health-related behaviours such as smoking, alcohol use and pre-existing health conditions among many patients that suffer a burn most likely explain this observed increase. Any persisting inflammatory or immune dysfunction following burn injury is unlikely to account for the increase in cancers in this study.
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Observational Study
Higher serum prealbumin levels are associated with higher graft take and wound healing in adult burn patients: A prospective observational trial.
Nutritional support is essential in burn care. There are few studies investigating the effect of nutrition on burn healing. The purpose of this study was to determine the relationship between perioperative serum prealbumin levels and the probability of autologous skin graft take in burned patients. ⋯ Perioperative serum prealbumin levels are significantly correlated with the probability of split-thickness skin autograft take in burned patients and with a reduced time to achieve complete epithelialization. They were an independent predictor of full graft take.
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Throughout the world, burn injury is a major cause of death and disability. In resource-limited countries, burn injury is one of the leading causes of permanent disability among children who survive traumatic injuries, and burn injury is the fourth leading cause of disability worldwide. This study applied Andersen's model of health care access to evaluate if patient characteristics (predisposing factors), burn care service availability (enabling factors) and injury characteristics (need) are associated with physical impairment at hospital discharge for patients surviving burn injuries globally. Specifically, access to rehabilitation, nutrition, operating theatre, specialized burn unit services, and critical care were investigated as enabling factors. The secondary aim was to determine whether associations between burn care service availability and impairment differed by country income level. ⋯ Access to reliable rehabilitation services and sophisticated nutritional services were strongly associated with less physical impairment at discharge, but only in resource-rich countries. Although these findings support the importance of rehabilitation and nutrition after burn injury, they also highlight potential disparities in the quantity or quality of services available to burn survivors in poorer countries.
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This study explored whether the use of virtual reality (VR) was a standard of care during burn care at burn verified facilities in the United States. Surveys were sent to American Burn Association verified burn centers to investigate if VR was being used as a standard of care, if protocols for using VR are in place and how they were developed, and what barriers these facilities are facing and several other topics investigated. Out of the 64 facilities surveyed, 21 responses were collected. ⋯ Out of the seven hospitals currently using VR, two reported a decrease in opioid use with burn care with the use of VR. Although the current results indicate that VR is not frequently used clinically during burn care at most burn centers, 83.3% of burn centers reported they see themselves using VR in the future. As VR becomes more widely disseminated, future research should be conducted to continue to see if VR is becoming a standard of care and whether VR is making clinical impacts on pain, opioid use, and level of anxiety among burn patients.