Improvement in early burn treatment has been realized, the mortality of burn shock has been decreased. However, the treatment of burn shock is still inadequate and occult hypoperfusion is usually occurred. This may be difficult to identify the appropriate resuscitation endpoint. The goal in management of burn shock is restoration of adequate tissue perfusion and normalization of cellular metabolism. Traditional endpoints, such as blood pressure, urine output are useful in managing mild and moderate burn shock. Additional endpoints that evaluate the adequacy of global and regional perfusion and oxygenation at the tissue level should be used in treatment of severe burn injury. Now the most useful parameters may be blood pressure, urine output, serum lactate, BE and CVP, SCVO2.
Burns ; physiopathology ; Humans ; Monitoring, Physiologic ; Shock ; physiopathology

Burn patients often suffer from different degrees of dysfunction, such as residual burn wounds, formation of hyperplastic scar, scar itching, cardiopulmonary dysfunction, limitation of motion, and psychological disorders, which exert severe impact on their daily life. This article reviews various rehabilitation treatments for dysfunction after burn injury to promote rehabilitation of burn patients.
Burns ; physiopathology ; rehabilitation ; China ; Humans ; Rehabilitation ; methods

OBJECTIVETo study the influence of high-voltage electric burn on the microcirculation of heart in rabbit.

METHODSOne-hundred and twenty New Zealand rabbits of clean grade were divided into control group (C) and electric burn group (EB) according to the random number table, with 60 rabbits in each group. Rabbits in EB group were subjected to high-voltage electric burn (the electrical current flow into the left foreleg at the lateral side of proximal end and out from the corresponding site of the right hind leg) with voltage regulator and experimental transformer. Rabbits in C group were sham injured with the same devices without electrification. At 15 minutes before injury, and 5 minutes, 1, 2, 4, 8 hour (s) post injury (PIM or PIH), ten rabbits in each group were chosen to examine the cardiac apex microcirculation hemoperfusion (CAMH) with laser Doppler hemoperfusion image instrument. The morphologic changes of microvessels of left ventricular wall tissues of 2 rabbits from each of the 10 rabbits collected at above-mentioned time points were observed with light microscope and transmission electron microscope. Auricular vein blood of rabbit was harvested at above-mentioned time points for the determination of aspartate amino transferase (AST), lactate dehydrogenase (LDH), hydroxybutyrate dehydrogenase (HBDH), creatine kinase (CK), and creatine kinase isozyme MB (CK-MB) by full-automatic biochemical analyzer. Data were processed with two-factor analysis of variance and LSD test.

RESULTS(1) The differences between C group and EB group in detection results were statistically significant, with F values from 425.991 to 3046.834, P values all below 0.01. Only the data within EB group were comparable. (2) At PIM 5, the CAMH value of rabbits in EB group was (1.96 ± 0.09) V, which was lower than that at 15 minutes before injury [(4.34 ± 0.35) V, P < 0.01]. The CAMH value of rabbits in EB group was increased at PIH 1 [(3.43 ± 0.30) V], and then it showed a tendency of decrease. (3) Bleeding and microthrombus formation were observed in venule and capillary vessel of rabbits in EB group at PIH 8. Breakage of basement membrane of capillary endothelial cells, mitochondrial swelling, and severe degranulation from damaged endoplasmic reticulum were observed in rabbits of EB group at PIH 8. (4) Levels of AST, LDH, HBDH, CK, and CK-MB in rabbits of EB group were significantly higher at PIH 1, 2, 4, 8 than at 15 minutes before injury (with P values all below 0.01). The AST level peaked at PIH 2 [(164 ± 39) U/L]. Levels of LDH and HBDH peaked at PIH 4, which were respectively (1016 ± 246) U/L and (487 ± 54) U/L. The CK level peaked at PIH 8 [(7799 ± 738) U/L]. The CK-MB level peaked at PIH 2 [(1848 ± 65) U/L].

CONCLUSIONSHigh-voltage electric burn can bring damage to the microvessels of heart in rabbits and change blood flow of microcirculation, which should be given adequate attention during the treatment.

Animals ; Burns, Electric ; physiopathology ; Heart ; physiopathology ; Hemodynamics ; Microcirculation ; Rabbits

Shock is one of the most important and common complications in the early stage following severe burn. This article focuses on the main advances in the roles and mechanism of vascular and cardiac factors in the pathogenesis of burn shock, and the new measures for prevention and treatment of it. Further studies are still needed to elucidate the precise mechanism of increased capillary permeability and the effective measures for decreasing fluid leakage from blood vessels, and to prevent hypoxic/ischemic damage and complications of visceral tissues arising thereof.
Blood Vessels ; physiopathology ; Burns ; complications ; physiopathology ; Heart ; physiopathology ; Humans ; Shock ; etiology ; physiopathology ; therapy

Burns ; complications ; immunology ; physiopathology ; Humans ; Hypoxia ; etiology ; immunology ; physiopathology ; Ischemia ; etiology ; immunology ; physiopathology

Ammonia is commonly used in industry and agriculture. It is also one of the most frequently accidentally spilled chemicals. Exposure to ammonia can cause severe cutaneous burn or freezing injury, ocular injury, and inhalation injury, among them inhalation injury is the most lethal one. Although the diagnosis and treatment of ammonia burns have been improved, the long-term prognosis is not satisfactory. In this article, we reviewed the literature concerning ammonia burns, in order to summarize the clinical features and treatment of such injury.
Ammonia ; adverse effects ; Burns, Chemical ; etiology ; physiopathology ; therapy ; Burns, Inhalation ; Humans ; Inhalation Exposure ; adverse effects ; Prognosis

Animals ; Burns ; complications ; Cicatrix ; etiology ; physiopathology ; Fetus ; physiopathology ; Humans ; Wound Healing

The index of monitoring burn shock resuscitation includes clinical signs and symptoms, laboratory examinations, hemodynamic variables. In recent years, there exists a tendency that the amount of transfused fluid for burn shock resuscitation is notably increased and complications of some cases, such as abdominal compartment syndrome have been reported. One of the major reasons for excessive fluid resuscitation is to try to normalize hemodynamic parameters with the help of invasive hemodynamic monitoring. Instead of hemodynamic variables, urinary output combined with other traditional variables still should be considered primary criteria of adequate fluid therapy. Specification of the variables of monitoring burn shock resuscitation is also the basis to revise and optimize the fluid resuscitation formula.
Burns ; physiopathology ; therapy ; Fluid Therapy ; Humans ; Monitoring, Physiologic ; Shock ; physiopathology ; therapy

OBJECTIVETo investigate therapeutics for and the pathological basis of combined radiation and burn injuries.

METHODSCombined radiation and burn injuries on mice and rats were inflicted by gamma ray irradiation from a (60)Co source and thermal radiation from a 5 kW bromotungsten lamp.

RESULTSThe dysfunction of myocardium played an important role in the development of early stage shock. Transfusion of irradiated (in vitro, 20 Gy) or stored (4 degrees C, 7 days) blood after irradiation was done to promote the success of allo-transplantation of bone marrow. Decrease of IL-4 mRNA expression was the molecular basis of depression of intestinal mucosa immune and intervention of IL-4 showed an antagonistic effect on enterogenic infection. A new lipid component extracted from burn eschar was documented for the first time and its toxic effects were elucidated. The survival rate of alloskin grafts after removal of burn eschar from the recipient animals was obviously increased in combined injury due to reduction of immune rejection activity by the radiation effect. In contrast, in animal models with simple burn, the alloskin grafts were all rejected within ten days after the procedure. A successful therapeutic result (survival rate: 92% for 30 days and 67% for 100 days) was obtained by comprehensive management of treated animals, while the untreated control animals all died within 3 - 7 days after injury.

CONCLUSIONThe pathogenesis of injury caused by simultaneous radiation and burn is extremely complicated and the treatment is very difficult. A comprehensive management program consisting of several therapeutic measures aimed at key links of the pathogenesis may achieve significantly improved results.

Animals ; Burns ; pathology ; physiopathology ; therapy ; Calcium ; metabolism ; Heart ; physiopathology ; Hematopoiesis ; Mice ; Radiation Injuries ; pathology ; physiopathology ; therapy ; Rats ; Rats, Wistar

Among the fire victims, respiratory tract injury resulted from smoke inhalation is the major cause of death. Particulate substances in smoke, toxic and harmful gas, and chemical substances act together would rapidly induce the occurrence of dramatic pathophysiologic reaction in the respiratory tract, resulting in acute injury to the respiratory tract, thus inducing serious injury to it and acute respiratory distress syndrome, leading to death of the victims. In recent years, the pathophysiologic mechanism of severe smoke inhalation injury has been gradually clarified, thus appreciable advances in its treatment have been achieved. This paper is a brief review of above-mentioned aspects.
Burns, Inhalation ; pathology ; physiopathology ; Fires ; Humans ; Respiratory Distress Syndrome, Adult ; physiopathology ; Smoke ; adverse effects ; Smoke Inhalation Injury ; pathology ; physiopathology