Burns : journal of the International Society for Burn Injuries
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Review Meta Analysis
Vasoconstrictor clysis in burn surgery and its impact on outcomes: Systematic review and meta-analysis.
Clysis is the subcutaneous or subdermal injection of a vasopressor containing fluid, with or without local anaesthetic agent, and has been used to limit blood loss in patients undergoing surgical burn management. In this systematic review and meta-analysis we aimed to determine the impact of clysis of a vasoconstrictor on burn patient outcomes. ⋯ Few studies have adequately evaluated the impact of clysis in burn surgery on patient important outcomes such mortality, duration of surgery and graft success. These results suggest clysis may reduce the need for blood transfusion but additional high quality research is required.
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Meta Analysis
Serum procalcitonin as a diagnostic biomarker for sepsis in burned patients: A meta-analysis.
Sepsis is one of the main causes of mortality in severe burns. However, it is difficult to diagnose early. Procalcitonin (PCT) has been reported as a biomarker for sepsis with controversial results. The aim of the study is to assess the diagnostic value of serum PCT for sepsis in burn patients through a meta-analysis of published studies. ⋯ The results suggest that serum PCT is a useful biomarker (AUC=0.92) for early diagnosis of sepsis in burn patients. However, the results should be used with caution, because of obvious heterogeneity among those studies. Further large-scale research should regard more attention to the uniform cut-off value, and laboratories test methods.
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Review Meta Analysis
A meta-analysis of trials using the intention to treat principle for glutamine supplementation in critically ill patients with burn.
During critical illness, the demand for glutamine may exceed that which can be mobilized from muscle stores. Infections increase mortality, morbidity, length-of-stay, antibiotic usage and the cost of care. This is a major health care issue. ⋯ Glutamine supplemented nutrition can be associated with a reduction in mortality in hospital, complications due to gram-negative bacteremia in burn patients. Further larger and better quality trials are required, in order to determine whether any differences are statistically and clinically important.
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Review Meta Analysis
A meta-analysis of analgesic and sedative effects of dexmedetomidine in burn patients.
Sedation for burn patients is provided by a variety of techniques determined usually by institutional preferences. The available pool of drugs has recently expanded to include dexmedetomidine (DEX), a α2-adrenergic receptor agonist with analgesic and sedative potential. Beneficial effects of DEX in burn patients have been described in many studies published over the last 5 years. ⋯ Even though there were only a small number of clinical trials available, the meta-analysis shows evidence for deeper and better sedation as well as for prevention of hypertension when using DEX as an adjunct during burn procedures. No evidence was found for reduced pain scores in this setting. The authors recommend the development of a prospective, randomized, controlled multicenter trial with an adequate number of patients to further elucidate the potentially beneficial effects of DEX for the management of burn patients.
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Review Meta Analysis
Extracorporeal membrane oxygenation in burn and smoke inhalation injury.
A systematic review and meta-analysis was conducted to assess the level of evidence for the use of extracorporeal membrane oxygenation (ECMO) in hypoxemic respiratory failure resulting from burn and smoke inhalation injury. We searched any article published before March 01, 2012. Available studies published in any language were included. ⋯ The role of ECMO in burn and smoke inhalation injury is therefore unclear. However, ECMO technology and expertise have improved over the last decades. Further research on ECMO in burn and smoke inhalation injury is warranted.