Acute and perioperative care of the burn-injured patient

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

    Research output: Contribution to journalArticle

    35 Citations (Scopus)

    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

    Fingerprint

    Perioperative Care
    Burns
    Wounds and Injuries
    Vascular Resistance
    Inhalation Burns
    Lung
    Operating Rooms
    Hypothermia
    Hypnotics and Sedatives
    Resuscitation
    Cardiac Output
    Opioid Analgesics
    Blood Vessels
    Edema
    Hemodynamics
    Pharmacology
    Guidelines
    Morbidity
    Pain

    ASJC Scopus subject areas

    • Anesthesiology and Pain Medicine

    Cite this

    Bittner, E. A., Shank, E., Woodson, L., & Martyn, J. A. J. (2015). Acute and perioperative care of the burn-injured patient. Anesthesiology, 122(2), 448-464. https://doi.org/10.1097/ALN.0000000000000559

    Acute and perioperative care of the burn-injured patient. / Bittner, Edward A.; Shank, Erik; Woodson, Lee; Martyn, J. A Jeevendra.

    In: Anesthesiology, Vol. 122, No. 2, 02.02.2015, p. 448-464.

    Research output: Contribution to journalArticle

    Bittner, EA, Shank, E, Woodson, L & Martyn, JAJ 2015, 'Acute and perioperative care of the burn-injured patient', Anesthesiology, vol. 122, no. 2, pp. 448-464. https://doi.org/10.1097/ALN.0000000000000559
    Bittner, Edward A. ; Shank, Erik ; Woodson, Lee ; Martyn, J. A Jeevendra. / Acute and perioperative care of the burn-injured patient. In: Anesthesiology. 2015 ; Vol. 122, No. 2. pp. 448-464.
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