ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The effect of infusion of fat emulsion on pulmonary function was determined in 18 patients with major burns and smoke inhalation injury. Lung compliance was monitored, as was arterial oxygenation, the latter by using the ratio of PaO2/FiO2. Mean burn size was 41% of total body surface area (TBSA). Preinfusion lung function was PaO2/FiO2=260 (normal >450). Chest x-rays were also monitored. Lipid emulsion was infused beginning on postburn day 3 for an eight-hour period each day. Average infusion was 900 cc of a 10% solution approximating 40% of calculated nonprotein calories. There was no change in lung function during or after infusion compared to the baseline value. Pulmonary edema was not evident on chest x-rays. Lipid was rapidly cleared from plasma, as evidenced by postinfusion triglyceride levels exceeding 300 mg/dl in only two patients. It seems that fat emulsion does not alter lung function in burn patients with an inhalation injury.

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

High-voltage electric injury is frequently complicated by significant long-term sequelae. Vascular lesions following electric injury include thrombosis, pseudoaneurysm formation, and spontaneous rupture. These complications have previously been believed to be confined to smaller vessels. Damage to the vessel walls contributes to the progressive tissue loss and necessity of extremity amputation that characterize a large percentage of these cases. A patient is discussed who sustained a highvoltage electric injury, followed by late abdominal aortic occlusion with distal embolization. The patient required multiple vascular reconstructive procedures and ultimately a below-knee amputation.

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The effects of hydrotherapy alone and hydrotherapy with sodium hypochlorite (NaOCl) on the number of bacteria on the surface of unburned and burned skin were examined. Hydrotherapy did not significantly reduce the number of bacteria in either skin category. The addition of various concentrations of NaOCl to the water in the hydrotherapy tank significantly decreased the number of bacteria on unburned and burned skin. However, treatment with this antiseptic agent in the tank water was associated with some side effects to patients and personnel, which has limited its use in our burn center.

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The mortality in 144 consecutive burn patients transferred to our burn center was compared to that to be expected using the Abbreviated Burn Severity Index (ABSI). No statistical difference was found whether helicopter or land-based transport was employed. Although mortality was not decreased by use of the helicopter, the guidelines established for its role were beneficial in treating the severely burned patient.

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The value of total creatine kinase and the isozymes for assessment of electric burns in seven patients was studied. The control group consisted of 15 patients with burns ranging from 5% to 70% of the body surface area. All patients with electric burns had marked elevation of total creatine kinase, the magnitude of the total enzyme elevation showing a strong relationship to the extent and number of extremity amputations required. Four of the seven patients had elevation of the MB (cardiac) fraction of isozyme, and each had significant abnormalities in the EKG.

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The effect of plasma exchange therapy during burn shock on circulating fibronectin levels was studied in 11 severely burned patients. The mean plasma fibronectin level in patients considered resuscitation failures (those requiring>1.5–2 times the calculated fluid requirement at six to eight hours postburn) was lower than in 20 patients undergoing normal resuscitation and having about the same percent TBSA (P<0.05). Plasma exchange with fresh frozen plasma (mean fibronectin content 287 ± 25 [SEM] µg/ml) replacement resulted in an increase— but not to “normal” levels of circulating fibronectin—of from 91 ± 69 to 204 ± 127 (SEM) µg/ml after the procedure. Plasma fibronectin levels remained lower than those in the control group and did not differ from the mean values in patients undergoing a routine uncomplicated resuscitation. These data suggest that removal of burn patients' plasma and its replacement with fresh frozen plasma during the burn shock period results in an increase in circulating fibronectin level but still does not prevent fibronectin deficiency in the overall postburn course.

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

A patient with a major thermal injury was found to have perforation of the transverse colon as well. The cause of this rare adjunct to burn is not known, but the theory is advanced that the transverse colon perforation was due to nonocclusive ischemic enterocolitis, which caused weakening of the bowel wall. Subsequent development of pseudo obstruction caused increased intraluminal pressure, which resulted in the colon perforation. The patient died 32 days post trauma and 23 days postcolon perforation of overwhelming candidiasis and cardiopulmonary and renal failure.

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Because studies on compliance with physical therapy regimens are apparently nonexistent in the literature, a questionnaire on this subject was sent to 90 burn care facilities in the United States and Canada. The questionnaire was designed to determine those aspects of physical therapy that meet with the least patient compliance, the methods used by therapists to improve cooperation, and which methods seem most successful. The responses indicated that the pediatric age group is least cooperative and that in patients of all ages, compliance is lowest in range of motion and stretching exercises and highest in activities of daily living. Techniques used most commonly by therapists to achieve compliance are: keeping to a regular (consistent) schedule; allowing periods of relaxation; and (surprisingly) use of scare tactics (ie, showing pictures of contractures). Among the psychosocial professionals who can be called upon to help therapists plan strategies for dealing with uncooperative patients, social workers are most often available on a fulltime basis, followed by psychologists and psychiatrists, who were more available on a consultation basis.

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID