Articles: burns.
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Infusionsther Transfusionsmed · Apr 1993
Randomized Controlled Trial Clinical Trial[Serum IgG concentrations and antibody titer of burn patients after preventive intravenous IgG substitution with a Pseudomonas immunoglobulin].
In a randomized clinical trial 30 patients with burn injury received supportive therapy with a Pseudomonas hyperimmunoglobulin (Psomaglobin N). The control group received no additional therapy. The patients of both groups were between 15 and 60 years of age and had a full-thickness burn of 30-70% of the body surface area with inhalational trauma being optional. ⋯ In the group receiving supportive treatment, 23 out of 30 patients had an inhalation trauma, and 8 of those (35%) died (1 of 7 patients without inhalation trauma). In both groups with inhalation injury, the patients were at risk of developing bacteremia: 13 of 23 of the immunoglobulin-treated patients and 12 of 16 patients of the control group. Bacteremic controls died at a lower score than bacteremic immunoglobulin-treated patients (8.6 vs. 10.3 points).(ABSTRACT TRUNCATED AT 250 WORDS)
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Surg Gynecol Obstet · Feb 1993
Randomized Controlled Trial Clinical TrialDiminishing blood loss during operation for burns.
The current placebo-controlled, randomized clinical trial was done to determine the effect of preoperative 1-desamino-8-D-arginine vasopressin (DDAVP) infusion on blood loss in patients undergoing burn débridement and grafting, a patient population in which extreme blood loss is a frequent occurrence. Eleven patients undergoing 22 surgical procedures completed the study protocol--mean age was 33 years (range of 12 to 70 years), mean burn size was 53 percent body surface area (BSA) (range of 17 to 92 percent) and mean area débrided and grafted was 3,935 centimeters squared (range of 848 to 8,134) or 21.1 percent (range of 4.0 to 43.5 percent) BSA. The treatment group received 0.3 microliter per kilogram DDAVP infused during 15 to 30 minutes within one hour of anesthetic induction. ⋯ No significant hemodynamic consequences or changes in routine coagulation profiles were noted in either group. No significant difference was found between the control and treatment groups in the volume of blood lost per percent BSA débrided and grafted (145.9 +/- 109.7 versus 130.2 +/- 61.7, respectively) or the volume lost per unit area débrided and grafted (0.75 +/- 0.54 versus 0.74 +/- 0.41, respectively). Based on these data, we cannot conclude that preoperative DDAVP infusion reduces blood loss in patients undergoing débridement and grafting of burn wounds.
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J Burn Care Rehabil · Sep 1992
Randomized Controlled Trial Clinical TrialA distraction technique for control of burn pain.
Research has indicated that analgesics alone do not adequately relieve pain for 75% of patients with burns. The purpose of this study was to determine the effects of a distraction therapy, in which videos were used in combination with administration of analgesics, on intensity and quality of pain and on levels of anxiety in adults during burn dressing changes. The sample consisted of 17 patients who were randomly assigned to the treatment or the control group. ⋯ Each was asked to score his or her present pain intensity and pain rating index with the McGill questionnaire and anxiety with the Spielberger questionnaire before and after the dressing change. A nested general linear model using the "F" test in multiple regression analysis was adjusted for age, percent partial-thickness burn, and choice of topical agent demonstrated that the use of videos during the dressing changes significantly reduced pain and anxiety: present pain intensity (F = 8.69; p = 0.01), pain rating index (F = 5.57; p = 0.03), anxiety (F = 9.10; p = 0.01). It is recommended that the use of pain medication be augmented by use of videos during burn dressing changes.
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Randomized Controlled Trial Comparative Study Clinical Trial
Patient-controlled analgesia: a double-blind study in burn patients.
A double-blind controlled study was performed to assess the efficacy and safety of patient-controlled analgesia in burn patients. This method was compared with conventional analgesic therapy consisting of intermittent intravenous morphine injections. Twenty-four adult patients hospitalised for burn injuries participated in the study. ⋯ Analysis of the side effects showed no difference between the groups. The amount of morphine administered over the trial period was also similar for the two groups but considerable interpatient variability was seen. Although further research is needed to determine the conditions for optimal use of patient-controlled analgesia, it is concluded that it is a safe, effective and improved method for controlling pain in selected burn patients.
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J Burn Care Rehabil · Nov 1991
Randomized Controlled Trial Comparative Study Clinical TrialBurn size estimate reliability: a study.
A study was undertaken to assess any differences between physicians' and nurses' estimates of burn size from drawings of 10 hypothetical patients with burns. Patient drawings were sent to the 199 burn facilities that are listed in the American Burn Association's Burn Care Resources in North America 1989-1990. The mailings were randomized between physicians and nurses. ⋯ Estimates of burn sizes with the use of standardized burn forms were consistently the same whether estimates were made by physicians or nurses. Sixty-eight percent of the respondents used the Rule of Nines or the Lund & Browder chart to estimate burn size, but 21% of the respondents failed to answer the question about which method is used in their units. In conclusion, there appears to be little variance in estimation of burn size as made by experienced burn nurses and physicians, and use of these estimates in a centralized data bank should be reliable.