Experimental evidence for a significant impairment of host defense for gram-negative organisms by a specific cutaneous toxin produced by severe burn injuries

1976 ◽  
Vol 16 (5) ◽  
pp. 420
Author(s):  
G. A. Schoenberger ◽  
David C. Colletti ◽  
DAVID B. PILCHER
2006 ◽  
Vol 50 (6) ◽  
pp. 1937-1945 ◽  
Author(s):  
Tyree H. Kiser ◽  
Dorie W. Hoody ◽  
Marilee D. Obritsch ◽  
Colleen O. Wegzyn ◽  
Paulus C. Bauling ◽  
...  

ABSTRACT Levofloxacin pharmacokinetics were studied in 11 patients with severe burn injuries. Patients (values are means ± standard deviations; age, 41 ± 17 years; weight, 81 ± 12 kg; creatinine clearance, 114 ± 40 ml/min) received intravenous levofloxacin at 750 mg (n = 10 patients) or 500 mg (n = one patient) once daily. Blood samples were collected on day 1 of levofloxacin therapy; eight patients were studied again on days 4 to 6. The pharmacodynamic probability of target attainment (PTA) was evaluated by Monte Carlo simulation. Mean systemic clearance, half-life, and area under the concentration-time curve over 24 h after levofloxacin at 750 mg were 9.0 ± 3.2 liters/h, 7.8 ± 1.6 h, and 93 ± 31 mg · h/liter, respectively. There were no differences in pharmacokinetic parameters between day 1 and day 4; however, large intrapatient and interpatient variability was observed. Levofloxacin pharmacokinetics in burned patients were similar to those reported in other critically ill populations. Levofloxacin at 750 mg achieved >90% PTA for gram-negative and gram-positive pathogens with MICs of ≤0.5 μg/ml and MICs of ≤1 μg/ml, respectively. However, satisfactory PTA was not obtained with less-susceptible gram-negative organisms with MICs of 1 μg/ml or any organism with a MIC of ≥2 μg/ml. The results of this study indicate that levofloxacin should be administered at 750 mg/day for treatment of systemic infections in severely burned patients. However, even 750 mg/day may be inadequate for gram-negative organisms with MICs of 1 to 2 μg/ml even though they are defined as susceptible. Alternative antibiotics or treatment strategies should be considered for infections due to these pathogens.


2002 ◽  
Vol 23 ◽  
pp. S77
Author(s):  
O. E. Suman ◽  
R. P. Mlcak ◽  
S. J. Thomas ◽  
D. N. Herndon

Author(s):  
George P Kozynets ◽  
Volodymyr P Tsyhankov ◽  
Daria S Korolova ◽  
Olga V Gornytska ◽  
Olexiy M Savchuk ◽  
...  

Abstract This work is dedicated to the detection of imbalance between the pro- and anti-coagulant branches of hemostasis at severe burn injuries by evaluating the content or activity of individual clotting factors. To select the targets for accurate diagnostics we measured the concentrations of soluble fibrin monomeric complexes and fibrinogen, levels of total prothrombin, factor X, protein C and antithrombin III, and recorded the time of clotting in activated partial thromboplastin time and prothrombin time tests. Factor X level was increased in 26 % of patients on the first day after the burn and it rose further in 62 % patients on the 14 th day of recovery. Increasing factor X level is assumed to be a risk factor of thrombotic complications. We propose to use it as a marker of predisposition to thrombosis at severe burn injury.


Inflammation ◽  
1996 ◽  
Vol 20 (3) ◽  
pp. 229-241 ◽  
Author(s):  
O. Ljunghusen ◽  
J. Lundahl ◽  
H. Nettelblad ◽  
B. Nilsson ◽  
F. Sj�gren ◽  
...  

2018 ◽  
Vol 34 ◽  
pp. 58-61 ◽  
Author(s):  
Nina Jovanovic ◽  
Admira Dizdarevic ◽  
Nedzad Dizdarevic ◽  
Amir Haracic ◽  
Lamija Gafurovic

Author(s):  
Vivek Gupta ◽  
Arnab Chanda

Abstract Severe burn injures lead to millions of fatalities every year due to lack of skin replacements. While skin is a very limited and expensive entity, split thickness skin grafting, which involves the projection of a parallel incision pattern on a small section of healthy excised skin, is typically employed to increase the expansion and cover a larger burn site. To date, the real expansion capacity of such grafts are low (<3 times) and insufficient for treatment of severe burn injuries. In this study, novel I-shaped auxetic incision patterns, which are known to exhibit high negative Poisson’s ratios, have been tested on the skin to investigate their expansion potential. Fourteen two-layer skin graft models with varying incision pattern parameters (i.e., length, spacing, and orientation) were developed using finite element modelling and tested under uniaxial and biaxial tensile loads. The Poisson’s ratio, meshing ratios, and induced stresses were quantified across all models. Graft models tested uniaxially along the orthogonal directions indicated opposite trends in generated Poisson’s ratios, as the length of the I-shape incisions were increased. Biaxially, with a symmetric and closely spaced I-shape pattern, graft meshing ratios up to 15.65 were achieved without overstressing the skin. Overall, the findings from the study indicated that expansion potentials much higher than that of traditional skin grafts can be achieved with novel I-shaped auxetic skin grafts, which would be indispensable for covering large wounds in severe burn injuries.


2011 ◽  
Vol 32 (2) ◽  
pp. 173-177 ◽  
Author(s):  
Robert Kraemer ◽  
Karsten Knobloch ◽  
Johan Lorenzen ◽  
Karl H. Breuing ◽  
Soeren Koennecker ◽  
...  

2020 ◽  
Vol 41 (3) ◽  
pp. 705-713
Author(s):  
Yingzi Huang ◽  
Guozhong Lv ◽  
Linlin Hu ◽  
Yunfu Wu ◽  
Nan Guo ◽  
...  

Abstract Previous studies and the concentration-dependent antibacterial actions of daptomycin suggested that a high dose would be needed for difficult-to-treat infections in burn patients. Here, we evaluated the effects of administration of low and high doses of daptomycin in patients with severe burn injuries. The study retrospectively analyzed 10 patients with severe burn injuries, using pharmacokinetic (PK) and pharmacodynamic (PD) evaluations of daptomycin doses given to combat serious infections. Daptomycin was administered as a single dose or by multiple doses intravenously at a standard dose of 6 mg/kg/d or a high dose of 12 mg/kg/d for 7 to 14 days. The serum concentrations of daptomycin from patients were analyzed by liquid chromatography–mass spectrometry/mass spectrometry (LC-MS/MS). Burn injury patients treated with high-dose daptomycin had a linear PK profile and a negative correlation between the AUC0–24 and Baux score (R2 = .953 and R2 = .801). The Cmax, AUC0–24, and t(h)½ increased significantly compared with patients given a standard dose. The efficacy of daptomycin against Staphylococcus aureus showed significantly higher rates of (AUC0–24)/MIC and Cmax/MIC after high-dose daptomycin compared with the standard dose, reflected in a significant correlation between a high dose and the Baux score (r = .976, P &lt; .001). Positive S. aureus cultures from two of three high-dose and none of two daptomycin low-dose patients converted from positive to negative after therapy. No serious adverse events or discontinuation of the drug occurred during the treatment period. Daptomycin doses up to 12 mg/kg/d were well tolerated in Chinese patients with severe burn injuries, which were complicated by infections with S. aureus.


Burns ◽  
1992 ◽  
Vol 18 (2) ◽  
pp. 121-126 ◽  
Author(s):  
A. Riis ◽  
M. Andersen ◽  
M.B. Pedersen ◽  
K.W. Hall

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