Critical care in the severely burned: Organ support and management of complications

Burn critical care is predicated on seven key factors: sufficient goal-directed fluid resuscitation; early burn excision and wound coverage; aggressive antimicrobial and source control of sepsis; aggressive nutritional support; active warming; aggressive physical, occupational, and respiratory therapy; and aggressive and continuous support of organ failures until such time as the patient can heal. This care has reduced mortality over the past three decades, in large part through the development of specialized units for the care of burned patients. In this chapter we discuss the organization of these units and the intellectual edifice underlying a practical approach to burn critical care.