Pneumatosis intestinalis in patients with severe thermal injury

Todd F.M. Huzar, John Oh, Evan M. Renz, Steven Wolf, Booker T. King, Kevin K. Chung, Christopher E. White, Edward Malin, Jonathan B. Lundy, Seung H. Kim, Lorne H. Blackbourne, Leopoldo C. Cancio

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Severe thermal injury is associated with pronounced changes in intestinal physiology, which may cause ischemia, infarction, and pneumatosis intestinalis (PI). PI is a pathologic condition defined as infiltration of gas into the gastrointestinal tract wall. Historically, PI prompted urgent surgery, yet some surgeons "watch and wait" to avoid the risks of a negative laparotomy. The authors reviewed experience with PI at a single burn center. They retrospectively identified burn center intensive care unit patients with radiographic or pathologic evidence of PI. Data included demographics, injury severity score, TBSA burned, operative findings, length of stay, and mortality. From January 2003 through August 2009, 1129 patients were admitted to the authors' burn center intensive care unit. Fifteen had PI. Twelve had radiographic evidence of PI, and 10 had PI associated with intestinal infarction. Nonsurvivors had lower base deficits (P = .02), higher lactate levels (P = .05), and required vasopressor support (P = .02) within 24 hours of developing PI. Massive intestinal infarction (P = .004) and open abdomens (P = .004) were more common among nonsurvivors. PI can be identified by radiologic or pathologic findings. The authors' experience with PI among patients with burn injury revealed a high mortality rate. Because of the association of bowel ischemia with PI, exploratory laparotomy should be strongly considered in patients with burn injury with radiographic evidence of PI.

Original languageEnglish (US)
JournalJournal of Burn Care and Research
Volume32
Issue number3
DOIs
StatePublished - May 1 2011
Externally publishedYes

Fingerprint

Burn Units
Hot Temperature
Infarction
Wounds and Injuries
Laparotomy
Intensive Care Units
Ischemia
Injury Severity Score
Mortality
Abdomen
Gastrointestinal Tract
Lactic Acid
Length of Stay
Gases
Demography

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Rehabilitation

Cite this

Huzar, T. F. M., Oh, J., Renz, E. M., Wolf, S., King, B. T., Chung, K. K., ... Cancio, L. C. (2011). Pneumatosis intestinalis in patients with severe thermal injury. Journal of Burn Care and Research, 32(3). https://doi.org/10.1097/BCR.0b013e318217f8f6

Pneumatosis intestinalis in patients with severe thermal injury. / Huzar, Todd F.M.; Oh, John; Renz, Evan M.; Wolf, Steven; King, Booker T.; Chung, Kevin K.; White, Christopher E.; Malin, Edward; Lundy, Jonathan B.; Kim, Seung H.; Blackbourne, Lorne H.; Cancio, Leopoldo C.

In: Journal of Burn Care and Research, Vol. 32, No. 3, 01.05.2011.

Research output: Contribution to journalArticle

Huzar, TFM, Oh, J, Renz, EM, Wolf, S, King, BT, Chung, KK, White, CE, Malin, E, Lundy, JB, Kim, SH, Blackbourne, LH & Cancio, LC 2011, 'Pneumatosis intestinalis in patients with severe thermal injury', Journal of Burn Care and Research, vol. 32, no. 3. https://doi.org/10.1097/BCR.0b013e318217f8f6
Huzar, Todd F.M. ; Oh, John ; Renz, Evan M. ; Wolf, Steven ; King, Booker T. ; Chung, Kevin K. ; White, Christopher E. ; Malin, Edward ; Lundy, Jonathan B. ; Kim, Seung H. ; Blackbourne, Lorne H. ; Cancio, Leopoldo C. / Pneumatosis intestinalis in patients with severe thermal injury. In: Journal of Burn Care and Research. 2011 ; Vol. 32, No. 3.
@article{113d71365b41459d9620c29bea41dfc5,
title = "Pneumatosis intestinalis in patients with severe thermal injury",
abstract = "Severe thermal injury is associated with pronounced changes in intestinal physiology, which may cause ischemia, infarction, and pneumatosis intestinalis (PI). PI is a pathologic condition defined as infiltration of gas into the gastrointestinal tract wall. Historically, PI prompted urgent surgery, yet some surgeons {"}watch and wait{"} to avoid the risks of a negative laparotomy. The authors reviewed experience with PI at a single burn center. They retrospectively identified burn center intensive care unit patients with radiographic or pathologic evidence of PI. Data included demographics, injury severity score, TBSA burned, operative findings, length of stay, and mortality. From January 2003 through August 2009, 1129 patients were admitted to the authors' burn center intensive care unit. Fifteen had PI. Twelve had radiographic evidence of PI, and 10 had PI associated with intestinal infarction. Nonsurvivors had lower base deficits (P = .02), higher lactate levels (P = .05), and required vasopressor support (P = .02) within 24 hours of developing PI. Massive intestinal infarction (P = .004) and open abdomens (P = .004) were more common among nonsurvivors. PI can be identified by radiologic or pathologic findings. The authors' experience with PI among patients with burn injury revealed a high mortality rate. Because of the association of bowel ischemia with PI, exploratory laparotomy should be strongly considered in patients with burn injury with radiographic evidence of PI.",
author = "Huzar, {Todd F.M.} and John Oh and Renz, {Evan M.} and Steven Wolf and King, {Booker T.} and Chung, {Kevin K.} and White, {Christopher E.} and Edward Malin and Lundy, {Jonathan B.} and Kim, {Seung H.} and Blackbourne, {Lorne H.} and Cancio, {Leopoldo C.}",
year = "2011",
month = "5",
day = "1",
doi = "10.1097/BCR.0b013e318217f8f6",
language = "English (US)",
volume = "32",
journal = "Journal of Burn Care and Research",
issn = "1559-047X",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Pneumatosis intestinalis in patients with severe thermal injury

AU - Huzar, Todd F.M.

AU - Oh, John

AU - Renz, Evan M.

AU - Wolf, Steven

AU - King, Booker T.

AU - Chung, Kevin K.

AU - White, Christopher E.

AU - Malin, Edward

AU - Lundy, Jonathan B.

AU - Kim, Seung H.

AU - Blackbourne, Lorne H.

AU - Cancio, Leopoldo C.

PY - 2011/5/1

Y1 - 2011/5/1

N2 - Severe thermal injury is associated with pronounced changes in intestinal physiology, which may cause ischemia, infarction, and pneumatosis intestinalis (PI). PI is a pathologic condition defined as infiltration of gas into the gastrointestinal tract wall. Historically, PI prompted urgent surgery, yet some surgeons "watch and wait" to avoid the risks of a negative laparotomy. The authors reviewed experience with PI at a single burn center. They retrospectively identified burn center intensive care unit patients with radiographic or pathologic evidence of PI. Data included demographics, injury severity score, TBSA burned, operative findings, length of stay, and mortality. From January 2003 through August 2009, 1129 patients were admitted to the authors' burn center intensive care unit. Fifteen had PI. Twelve had radiographic evidence of PI, and 10 had PI associated with intestinal infarction. Nonsurvivors had lower base deficits (P = .02), higher lactate levels (P = .05), and required vasopressor support (P = .02) within 24 hours of developing PI. Massive intestinal infarction (P = .004) and open abdomens (P = .004) were more common among nonsurvivors. PI can be identified by radiologic or pathologic findings. The authors' experience with PI among patients with burn injury revealed a high mortality rate. Because of the association of bowel ischemia with PI, exploratory laparotomy should be strongly considered in patients with burn injury with radiographic evidence of PI.

AB - Severe thermal injury is associated with pronounced changes in intestinal physiology, which may cause ischemia, infarction, and pneumatosis intestinalis (PI). PI is a pathologic condition defined as infiltration of gas into the gastrointestinal tract wall. Historically, PI prompted urgent surgery, yet some surgeons "watch and wait" to avoid the risks of a negative laparotomy. The authors reviewed experience with PI at a single burn center. They retrospectively identified burn center intensive care unit patients with radiographic or pathologic evidence of PI. Data included demographics, injury severity score, TBSA burned, operative findings, length of stay, and mortality. From January 2003 through August 2009, 1129 patients were admitted to the authors' burn center intensive care unit. Fifteen had PI. Twelve had radiographic evidence of PI, and 10 had PI associated with intestinal infarction. Nonsurvivors had lower base deficits (P = .02), higher lactate levels (P = .05), and required vasopressor support (P = .02) within 24 hours of developing PI. Massive intestinal infarction (P = .004) and open abdomens (P = .004) were more common among nonsurvivors. PI can be identified by radiologic or pathologic findings. The authors' experience with PI among patients with burn injury revealed a high mortality rate. Because of the association of bowel ischemia with PI, exploratory laparotomy should be strongly considered in patients with burn injury with radiographic evidence of PI.

UR - http://www.scopus.com/inward/record.url?scp=79955949201&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79955949201&partnerID=8YFLogxK

U2 - 10.1097/BCR.0b013e318217f8f6

DO - 10.1097/BCR.0b013e318217f8f6

M3 - Article

C2 - 21422942

AN - SCOPUS:79955949201

VL - 32

JO - Journal of Burn Care and Research

JF - Journal of Burn Care and Research

SN - 1559-047X

IS - 3

ER -