scholarly journals Association Between Serum Albumin And The Success Of Fluid Resuscitation In Children Hospitalizen In Cipto Mangunkusumo Hospital Burn Center

2019 ◽  
Vol 5 (2) ◽  
pp. 226-233
Author(s):  
Rismala Dewi ◽  
Karina Kaltha ◽  
Aditya Wardhana ◽  
Piprim B. Yanuarso
Keyword(s):  
Serum Albumin ◽  
Fluid Resuscitation ◽  
Sampling Method ◽  
Burn Injury ◽  
Significant Loss ◽  
Mortality And Morbidity ◽  
Burn Center ◽  
Pediatric Resuscitation ◽  
Almost All ◽  
Burn Patient

Background : Burn injury has a great impact on mortality and morbidity in children. Significant loss of albumin (hypoalbuminemia) in burn patient often leads to serious complications. However, it is still unclear whether serum albumin has a role in the success of fluid resuscitation in children with burn injury. Method : This is a retrospective cohort study based on medical record of children hospitalized with burn injury at Cipto Mangunkusumo Hospital Burn Centre from January 2012-March 2018. The subjects collected with the total sampling method. Result : Most burn injury happen because of scalds, and have grade 2 burn injury with PELOD score<10. Almost all subjects was succesfully resuscitated in the first 24 hour (95,1%). No association was found between the success of fluid resuscitation with either serum albumin [RR 1,175(95%CI 0,3-4,4) p=0,812], or with ureum, creatinin, lactate level, weight and the degree/extent of the burn injury. Conclusion: The success rate of fluid resuscitation in pediatric burn injury was quite high in Cipto Mangunkusumo Hospital Burn Centre. No association was found between serum albumin and the success of fluid resuscitation during the first 24 hour period. Keywords: albumin, burn, pediatric, resuscitation  

510 A Case-controlled Retrospective Review of Fluid Resuscitation in Patients with Concomitant Burn and Trauma Injuries

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S102-S102
Author(s):  
Kevin N Foster ◽  
Christopher Mellon ◽  
Claudia Islas ◽  
Soraya Smith ◽  
Vanessa Davis ◽  
...  
Keyword(s):  
Fluid Resuscitation ◽  
Injury Severity ◽  
Burn Injury ◽  
Primary Objective ◽  
Hospital Length Of Stay ◽  
Trauma Patients ◽  
Blood Products ◽  
Burn Center ◽  
Aggressive Fluid Resuscitation ◽  
Burn Resuscitation

Abstract Introduction Aggressive fluid resuscitation with crystalloid has been a mainstay of therapy in burn injuries for over 50 years. However, in trauma populations there has been a shift away from crystalloid based resuscitation and the early administration of blood products has been recommended. The primary objective of this study was to evaluate if large-volume crystalloid resuscitation of patients presenting with both burn and trauma injuries is associated with higher mortality and complications. Methods This was a matched case-controlled retrospective chart review of patients treated over a 5-year period that suffered mixed burn and trauma injuries (MI). Patients that suffered burn only injuries (BO) were used as the control and were matched on TBSA, age, and gender. All patients were resuscitated using the standard burn center resuscitation protocol. Results A total of 4,416 patients were admitted to the burn center during the study period. Of those 18 had concomitant burn and trauma injuries requiring burn fluid resuscitation and were successfully matched to BO patients. There was no difference in age, gender, ethnicity, % TBSA burned, presence of inhalation injury, or Injury Severity Score (ISS). BO patients were more likely to have flame/flash as the etiology of burn injury (p=.0257). With fluid resuscitation, there was no difference in the total volume of fluid administered, or the amount of crystalloid or colloid administered. MI patients were more likely to have received blood products than BO patients (472 ml vs 19 ml, p=.0387). There was no difference in the following outcome measures: mortality, ICU days, ventilator days, number of surgeries, infections, or major complications. The only significant outcome difference was that the BO patients had a greater hospital length of stay (44 days) than the MI patients (24 days, p &lt; 0.001). Conclusions Aggressive fluid resuscitation using existing burn resuscitation protocols did not result in greater complications in burn-trauma patients than in burn only patients. Crystalloid-based burn resuscitation is safe in patients with combined burn and trauma injuries.

scholarly journals TREATMENT OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) SEPSIS WITH COMBINATION OF FOSFOMYCIN AND AMIKACIN IN A PATIENT WITH SCALD-BURN INJURY

2018 ◽  
Vol 11 (15) ◽  
pp. 17 ◽  
Author(s):  
Oki Nugraha Putra ◽  
Iswinarno Doso Saputro ◽  
Ana Khusnul F
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Burn Injury ◽  
Definitive Treatment ◽  
Once Daily ◽  
Burn Center ◽  
Alternative Treatment Option ◽  
Empiric Antibiotic ◽  
Mrsa Infection ◽  
Burn Patient

Objective: Thus, this case report assesses the efficacy combination of fosfomycin and amikacin in the management of MRSA infection in a burn patient.Case Report: A 31-year-old male was transferred to the burn center for definitive treatment. Initially, the patient was treated with ceftazidime injection as empiric antibiotic one gram three times daily, but the patient became sepsis during the treatment. Blood specimen was taken and Methicilin Resistant Staphylococcus aureus (MRSA) was isolated from this culture. The patient was isolated and based on antibiotic susceptibility, the patient was started on fosfomycin 2 gram IV twice daily for first seven days, and after that fosfomycin was combined with amikacin IV 500 mg once daily. After administration of these antibiotics, a rapid clinical improvement was observed with the patient, leucocytosis did not occur and blood culture was negative. The patient completed a total of 14 days of fosfomycin and 8 days of amikacin therapy.Conclusion: The synergistic combination of fosfomycin with amikacin, may be useful alternative treatment option for sepsis related Methicilin- Resistant Staphylococcus aureus (MRSA) in burn injury. Further research is also needed to clarify effectiveness of fosfomycin and amikacin to treat MRSA infection in burn patient.

Impact of COVID 19 Pandemic on Tuerculosis

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1084-1088
Author(s):  
Deepanshu Chawla ◽  
Pankaj Wagh ◽  
Saood Ali ◽  
Ulhas Jadhav ◽  
Babaji Ghewade
Keyword(s):  
Hand Hygiene Compliance ◽  
Adverse Outcome ◽  
Central India ◽  
Lung Compliance ◽  
Significant Loss ◽  
Tuberculosis Control ◽  
Mortality And Morbidity ◽  
Airborne Infection ◽  
Hygiene Compliance ◽  
Economic Constraints

Covid19 or SARS COV 2 is the most dreaded pandemic of the century, causing widespread mortality and morbidity. On the other hand, tuberculosis is an age-old disease killing billions around the globe every year. Both the diseases have caused a significant loss of human lives along with socio-economic constraints. While SARS Cov 2 is a very new disease, tuberculosis is known to humanity for thousands of years. Tuberculosis is an airborne infection while Covid spreads via droplet spread and through fomite as well. Tuberculosis and complications related to it may lead to increased mortality due to poor lung compliance. Moreover, Tuberculosis control programmed may get affected due to the ongoing pandemic. To decrease the adverse outcome of Covid19 on Tb strict measures like proper social distancing, hand hygiene, compliance to Anti Tubercular drugs, domiciliary Tb care and strengthening immune system may prove important. Measures like the use of masks, proper cough hygiene and repeated washing of hands may play a role in decreasing the spread of tuberculosis as well and might also play a role in the elimination of tuberculosis. The article also highlights the measures taken in a rural hospital in central India for the management of COVID 19 and Tuberculosis and the possible difficulties faced in the management of tuberculosis during the Covid pandemic.

scholarly journals Pediatric burn resuscitation: past, present, and future

2017 ◽  
Vol 5 ◽  
Author(s):  
Kathleen S. Romanowski ◽  
Tina L. Palmieri
Keyword(s):  
Fluid Resuscitation ◽  
Burn Injury ◽  
Total Body Surface Area ◽  
Burn Shock ◽  
Basic Principles ◽  
Future Directions ◽  
Number Of Children ◽  
History Of ◽  
Adults And Children ◽  
Total Body

Abstract Burn injury is a leading cause of unintentional death and injury in children, with the majority being minor (less than 10%). However, a significant number of children sustain burns greater than 15% total body surface area (TBSA), leading to the initiation of the systemic inflammatory response syndrome. These patients require IV fluid resuscitation to prevent burn shock and death. Prompt resuscitation is critical in pediatric patients due to their small circulating blood volumes. Delays in resuscitation can result in increased complications and increased mortality. The basic principles of resuscitation are the same in adults and children, with several key differences. The unique physiologic needs of children must be adequately addressed during resuscitation to optimize outcomes. In this review, we will discuss the history of fluid resuscitation, current resuscitation practices, and future directions of resuscitation for the pediatric burn population.

A survey of YouTube videos as a source of useful/un-useful information in the field of the prevention and management of burn injuries: A cross-sectional analysis of the English language content

2021 ◽  
Author(s):  
Kayhan Gurbuz ◽  
Mete Demir ◽  
Koray Das
Keyword(s):  
English Language ◽  
Burn Injury ◽  
Significant Loss ◽  
Burn Injuries ◽  
Cross Sectional ◽  
Global Quality ◽  
Content Ratio ◽  
Media Platform ◽  
Youtube Videos

Abstract The study was designed on whether YouTube videos are useful as an information resource in the field of burn injury prevention and management. Current literature on the educational content and quality of burn-related first aid videos on YouTube was reported as inadequate and inaccurate. However, the quality of YouTube videos on various medical and clinical topics has been the subject of many previous studies, and there has been increasing evidence that the content ratio of usefulness was higher than that of non-useful. While hours and even minutes in burn injuries are as precious as gold in terms of outcomes, it would be a significant loss not to use the most popular and easily accessible free social media platform of our time as a tool that can contribute to the prevention of burns and raise awareness. Analysis was conducted with the remaining 96 videos from 240 videos obtained from YouTube, according to possible search terms and exclusion of videos according to predetermined criteria. The Global Quality Score (GQS) and modified DISCERN (m.DISCERN) tools were used to assess the quality and reliability of the videos. Viewer engagement metrics and video properties were also investigated according to the usefulness criteria (e.g., video length, duration on YouTube, topic contents, source uploads, reliability, and quality). Finally, it was revealed that nearly 80 percent of the YouTube videos contained information in the field of the prevention and management of burn injuries deemed useful in this study, comparable to the other medical disciplines' reports in the literature.

scholarly journals Factors Affecting the Perception and Practice of Iranian Nomadic and Semi-Nomadic Pastoralists in Regard to Biosecurity Practices in Sheep and Goat Farms: A Cross-Sectional and Prospective Study

Ruminants ◽  
2022 ◽  
Vol 2 (1) ◽  
pp. 54-73
Author(s):  
Zeinab Hatami ◽  
Richard A. Laven ◽  
Saeid Jafari-Gh. ◽  
Mahdi Moazez-Lesko ◽  
Pegah Soleimani ◽  
...  
Keyword(s):  
Prevention Measures ◽  
Extension Programs ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Factors Affecting ◽  
Nomadic Pastoralists ◽  
Almost All ◽  
Biosecurity Practices ◽  
Umbilical Cords ◽  
Annual Mortality

Preventing the spread of diseases between and within farms (biosecurity) is essential for minimizing animal mortality and morbidity, as well as for reducing the risk of spread of zoonotic diseases. These effects are even greater in countries such as Iran, which have to deal with multiple ongoing epidemics of infectious disease. However, there is currently no published information about biosecurity practices on sheep and goat farms in Iran in published research. The aim of this study was to collect such information and to identify some of the factors affecting biosecurity practices. Data were gathered using a checklist and in-depth interviews with 99 nomadic and semi-nomadic pastoralists. Regression analysis was used to identify the relationships between the collected variables and the biosecurity scores. The results showed that neither within- nor between-farm disease prevention measures were appropriately applied on most farms (median total score of total biosecurity was 37.3/90; Q1 = 29.0 and Q3 = 44.7). Almost all the farmers reported slaughtering animals on farms and nobody properly disposed of the bodies of the dead animals. Additionally, the majority of the participants did not disinfect the umbilical cords of newborns. Of the collected variables, the annual mortality rate was associated with most within-farm biosecurity practices. The increase in annual mortality rates was associated with the regular cleaning of troughs (p = 0.03), preventing feed and water from being contaminated by urine and feces (p = 0.02), providing a clean and dry place for animals to rest (p = 0.05) and disinfecting the navel cord (p = 0.03). The results of this survey suggest that there is a clear need for extension programs to enhance Iranian and sheep and goat farmers’ perceptions and practices regarding biosecurity measures.

scholarly journals The Effect of Parenteral Infusion of Amino Acids in Burn Patient

2013 ◽  
Vol 24 (1) ◽  
pp. 12-15
Author(s):  
Kamrun Nahar ◽  
Zeba-un Naher ◽  
Matira Khanam ◽  
Shaheen Akhter ◽  
Tahmina Bashar ◽  
...  
Keyword(s):  
Amino Acid ◽  
Serum Albumin ◽  
Total Protein ◽  
Burn Injury ◽  
Burn Patients ◽  
Serum Total Protein ◽  
Female Ratio ◽  
Group I ◽  
The Mean ◽  
Group Ii

Adequate nutritional support may prevent weight loss  following severe burn injury. However, persistently low  levels of serum albumin, transferring and serum total  protein in burn patients have suggested that a protein  deficiency may continue to exist which is out of proportion  to energy requirements.  This interventional study cross sectional study was done in  the Department of Biochemistry, Bangabandhu Sheikh  Mujib Medical University (BSMMU), Dhaka, Bangladesh  during January 2008 to December 2008. A total of 40 acute  burn injury (within 24 hours of burn) patients of 20-45  years age with 15%-30% burn were selected for this study  as case. The study subjects were divided into two groups:  Group I represent superficial burn & Group II represents  deep burn.  The mean age of 28.35±6.81 years and 30.85±7.32 years in  group I and group II respectively. The number of male in  Group-I was 08 and Group-II was 08 and male female ratio  was 2:3. The mean serum total protein before infusion of  amino acid in Group-I was 55.31±3.58 g/L and in Group-II  was 52.01±2.26 g/L (p<0.001). The mean serum total  protein after infusion of amino acid in Group-I was  68.02±2.04 g/L and in Group-II was 61.86±2.49g/L  (p<0.001). The mean serum albumin before infusion of  amino acid in Group-I was 27.6±2.88 g/L and in Group-II  was 25.57±1.89 g/L (p<0.001). The mean serum albumin  after infusion of amino acid in Group-I was 22.29±3.50 g/L  and in Group-II was 19.83±2.86 g/L (p<0.001). In group-I,  serum total protein was increased by 22.98% after infusion  and in group-II, that was increased by 18.94% (p<0.01).  In group-I, serum albumin was decreased by 19.24% after  infusion and in group-II, that was decreased by 22.45%  (p<0.05). Serum total protein significantly increased after  infusion of amino acid but serum albumin significantly  decreased after infusion of amino acid. DOI: http://dx.doi.org/10.3329/medtoday.v24i1.14107 Medicine TODAY Vol.24(1) 2012 pp.12-15

530 Osteomyelitis Increases the Rate of Amputation in Patients with Type 2 Diabetes and Lower Extremity Burns

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S102-S103
Author(s):  
Rabia Nizamani ◽  
Stephen Heisler ◽  
Lori Chrisco ◽  
Harold Campbell ◽  
Samuel W Jones ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lower Extremity ◽  
Burn Injury ◽  
Total Body Surface Area ◽  
Amputation Rate ◽  
Diabetic Patients ◽  
Inpatient Hospitalization ◽  
Burn Center ◽  
Hospitalization Costs

Abstract Introduction In patients with type 2 diabetes (DM2), amputation rates exceed 30% when lower extremity osteomyelitis is present. We sought to determine the rate of osteomyelitis and any subsequent amputation in our patients with DM2 and lower extremity burns. Methods We performed a single site, retrospective review at our burn center using the institutional Burn Center registry with links to clinical and administrative data. Adults (≥18 years old) with DM2 admitted from January 1, 2014 to December 31, 2018 for isolated lower extremity burns were eligible for inclusion. We evaluated demographics, burn characteristics, comorbidities, admission laboratory values, presence of radiologically-confirmed osteomyelitis, length of stay (LOS), inpatient hospitalization costs, and amputation rate at 3 months and 12 months after injury. Statistical analysis was performed with Students’ t-test, chi-squared, and Fischer’s exact test. Results For 103 patients identified with DM2 and isolated lower extremity burns, the average age was 54 years old. The majority of patients were male (78.6%) and white (55.3%). The average total body surface area (TBSA) of burn was 1.8% and 53.4% were scald burns. Thirty percent of patients had a history of heart disease and 22% were current smokers. The average hemoglobin A1c was 9.19 and average creatinine was 2.01. Overall rates of any amputation were 14.6% at 3 months and 18.4% at 12 months. Fifteen patients (14.6%) had radiologically-confirmed osteomyelitis within 90 days of the burn injury. Compared to patients without osteomyelitis, this subset of patients had significantly increased LOS (average LOS 22.7 days vs 12.1 days, p=0.0041), inpatient hospitalization costs (average $135,345 vs $62,237, p=0.0008), amputation rate within 3 months (66.7% vs 5.70%, p&lt; 0.00001), and amputation rate within 12 months (66.7% vs 10.2%, p&lt; 0.0001). There were no significant differences in other characteristics between patients with osteomyelitis and those without. Conclusions Patients with DM2 and lower extremity burns incurred increased LOS, higher inpatient hospitalization costs, and increased amputation rates if radiologically-confirmed osteomyelitis was present. Applicability of Research to Practice Osteomyelitis in diabetic patients with lower extremity burns may predict need for amputation within one year of burn injury. Further study could aid in development of protocols for early identification and aggressive treatment of osteomyelitis in burn patients, which may improve LOS, cost, and amputation rates.

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