Critical Care in Burns

Severe burns represent around 436,000 ambulatory care visits to hospital emergency departments in the United States [1]. A significant portion of these burns are minor; nevertheless between 40,000 and 60,000 burn patients undergo admission to a hospital [2]. Of all cases, nearly 4000 people die of complications related to the burn [3]. During the 1940s and 1950s, the burn size lethal to 50% of the population was 42% of total body surface area (TBSA). More recently, this number has increased to more than 90% TBSA in selected groups of patients. The devastating consequences of burns have been recognized by the medical community, and significant amounts of resources and research have been dedicated to improve our understanding and enhancing the way we manage patients, successfully improving these dismal statistics [3–5]. This significant improvement is secondary to the establishment of specialized burn centers, refinements in resuscitation strategies, advances in critical care, sepsis management and infection control, early excision of burn wounds, enhanced wound coverage, better support on the metabolic response to burns, and improved treatment of inhalation injury [5, 6].