Acute and perioperative care of the burn-injured patient

Edward A. Bittner, Erik Shank, Lee Woodson, J. A.Jeevendra Martyn

    Research output: Contribution to journalReview articlepeer-review

    74 Scopus citations

    Abstract

    Care of burn-injured patients requires knowledge of the pathophysiologic changes affecting virtually all organs from the onset of injury until wounds are healed. Massive airway and/or lung edema can occur rapidly and unpredictably after burn and/or inhalation injury. Hemodynamics in the early phase of severe burn injury is characterized by a reduction in cardiac output and increased systemic and pulmonary vascular resistance. Approximately 2 to 5 days after major burn injury, a hyperdynamic and hypermetabolic state develops. Electrical burns result in morbidity much higher than expected based on burn size alone. Formulae for fluid resuscitation should serve only as guideline; fluids should be titrated to physiologic endpoints. Burn injury is associated basal and procedural pain requiring higher than normal opioid and sedative doses. Operating room concerns for the burn-injured patient include airway abnormalities, impaired lung function, vascular access, deceptively large and rapid blood loss, hypothermia, and altered pharmacology.

    Original languageEnglish (US)
    Pages (from-to)448-464
    Number of pages17
    JournalAnesthesiology
    Volume122
    Issue number2
    DOIs
    StatePublished - Feb 2 2015

    ASJC Scopus subject areas

    • Anesthesiology and Pain Medicine

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