523 Retrospective Outcomes Analysis of Tracheostomy in Paediatric Burn Population

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S108-S109
Author(s):  
Nicholas Iglesias ◽  
Anesh Prasai ◽  
George Golovko ◽  
Deepak K Ozhathil ◽  
Steven E Wolf
Keyword(s):  
Inhalation Injury ◽  
Smoke Inhalation ◽  
Research Network ◽  
Burn Patients ◽  
Pulmonary Injury ◽  
Smoke Inhalation Injury ◽  
Mortality And Morbidity ◽  
Laryngeal Injury ◽  
Icd 10 ◽  
Potential Benefits

Abstract Introduction For decades, controversy has raged regarding the placement of tracheostomy in severe paediatric burns. Numerous variables including extent of smoke inhalation injury, % TBSA burned, age of the patient, and co-morbidities among others complicate reaching consensus. Furthermore, paediatric patients are particularly susceptible to complications including inadvertent loss of airway and long-term swallowing and other anatomic issues. Additionally, previous analysis of the efficacy of tracheostomy in paediatric burn patients appears to be hindered by a lack of nationwide analysis. The aim of this study was to explore the efficacy of tracheostomy in the general paediatric burn patient population. Methods De-identified patient data was obtained from the TriNetX Research Network database. Two cohorts were identified: paediatric burn patients with tracheostomy (cohort A) and paediatric burn patients without tracheostomy (cohort B). Burn patients were identified using the ICD-10 codes T20-T25 & T30-T32. Tracheostomy was identified using the ICD-10 codes 1005887, 1014613, 31600, 31601, 31603, 31604, 31610, and Z93.0. A total of 132 patients were identified in cohort A in 23 HCOs and 83,117 patients were identified in cohort B in 38 HCOs. Infection, hypovolemia, pulmonary injury, laryngeal injury, pneumonia, and death were compared between the cohorts. Results Cohort A had a mean age of 11 (SD=5) and Cohort B had a mean age of 9 (SD=5). Paediatric burn patients with tracheostomy had a higher risk for death, infection, hypovolemia, pulmonary injury, laryngeal injury, and pneumonia when compared to their non-tracheostomy counterparts. The risk ratios for these outcomes were 62.452, 4.713, 9.267, 26.483, 116.163, and 18.154, respectively. Conclusions The analysis of the longitudinal outcomes of pediatric burn patients with tracheostomy as compared to those without tracheostomy demonstrated the tracheostomy cohort suffered much worse mortality and morbidity across several metrics. The potential benefits of tracheostomy placement in pediatric burn patients should be weighed against these outcomes.

519 The Routine Addition of Maintenance IV Fluid is Not Warranted during all Pediatric Burn Resuscitation: A Retrospective Study

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S106-S107
Author(s):  
Prabhu Senthil-Kumar ◽  
Madeline Zieger ◽  
Brett C Hartman
Keyword(s):  
Oral Intake ◽  
Inhalation Injury ◽  
Smoke Inhalation ◽  
Wound Complications ◽  
Burn Patients ◽  
Smoke Inhalation Injury ◽  
Resuscitation Fluid ◽  
Pediatric Burns ◽  
Age Range ◽  
Burn Resuscitation

Abstract Introduction Pediatric burn resuscitation has improved dramatically over the years with improved survival and outcomes. Recent studies have shown the amount of fluid given (ml/kg/%TBSA) has direct correlation to the outcomes. Over resuscitation (fluid creep) results in multiple systemic and wound complications. We hypothesize the addition of maintenance IV fluid with Parkland resuscitation fluid in younger pediatric burns (< 30kg) may not be needed to achieve adequate end points of resuscitation. Methods We performed a retrospective chart analysis of our pediatric burn patients at our institution by categorizing younger patients (< 30kg) into two groups: The maintenance IV fluid (MF) group and the resuscitation fluid (RF) only group. We identified 18 patients that met the criteria with 9 patients in each group. All of the patients in both groups were under 30kg, age range 2-8yrs, and TBSA: 16–50 %. We included 3 patients under 20% TBSA that were resuscitated due to full thickness burns and smoke inhalation injury. We analyzed their hourly and 24-hour fluid administration including all oral intake and tube feeds as well as their hourly vitals, urine output, and laboratory values during the resuscitation. Results We found that the RF group received 1.311+/- 1.295 cc/kg cc less fluid compared to the MF group without any hypoglycemic events or deleterious hemodynamic effects. The patients who had good oral intake or received tube feeds during resuscitation resulted in significantly less resuscitation volume than the estimated resuscitation volume in both groups. Conclusions We conclude that resuscitation can be safely done in pediatric burn patients under 30 kg without adding routine maintenance IV fluid. Early oral and enteral feeding is very critical in all burn patients. The volume that was administered enterally should also be considered in hourly fluid titration rates to reduce the resuscitation fluids given thereby preventing fluid creep and ensuing deleterious complications.

232 Toxic Compounds in Burn Patients with Smoke Inhalation Injury

2018 ◽  
Vol 39 (suppl_1) ◽  
pp. S83-S83
Author(s):  
T Tran ◽  
R Karlnoski ◽  
K Bolling ◽  
K Brown Maynell ◽  
L Taylor ◽  
...  
Keyword(s):  
Inhalation Injury ◽  
Smoke Inhalation ◽  
Burn Patients ◽  
Smoke Inhalation Injury ◽  
Toxic Compounds

scholarly journals Bilateral Lobar Lung Transplantation after Smoke Inhalation Injury - A Case Report

2021 ◽  
Vol 40 (4) ◽  
pp. S515
Author(s):  
E. Olsson ◽  
M. Silverborn ◽  
U. Smedh ◽  
G.C. Riise ◽  
J.M. Magnusson ◽  
...  
Keyword(s):  
Case Report ◽  
Lung Transplantation ◽  
Inhalation Injury ◽  
Smoke Inhalation ◽  
Smoke Inhalation Injury

Role of anti-L-selectin antibody in burn and smoke inhalation injury in sheep

2002 ◽  
Vol 283 (5) ◽  
pp. L1043-L1050 ◽  
Author(s):  
Jiro Katahira ◽  
Kazunori Murakami ◽  
Frank C. Schmalstieg ◽  
Robert Cox ◽  
Hal Hawkins ◽  
...  
Keyword(s):  
Leukocyte Adhesion ◽  
Experimental Period ◽  
Inhalation Injury ◽  
Lymph Flow ◽  
Smoke Inhalation ◽  
Control Group ◽  
Fluid Flux ◽  
Smoke Inhalation Injury ◽  
Lung Lymph ◽  
Lung Lymph Flow

We hypothesized that the antibody neutralization of L-selectin would decrease the pulmonary abnormalities characteristic of burn and smoke inhalation injury. Three groups of sheep ( n = 18) were prepared and randomized: the LAM-(1–3) group ( n = 6) was injected intravenously with 1 mg/kg of leukocyte adhesion molecule (LAM)-(1-3) (mouse monoclonal antibody against L-selectin) 1 h after the injury, the control group ( n = 6) was not injured or treated, and the nontreatment group ( n = 6) was injured but not treated. All animals were mechanically ventilated during the 48-h experimental period. The ratio of arterial Po 2 to inspired O2 fraction decreased in the LAM-(1–3) and nontreatment groups. Lung lymph flow and pulmonary microvascular permeability were elevated after injury. This elevation was significantly reduced when LAM-(1–3) was administered 1 h after injury. Nitrate/nitrite (NO x ) amounts in plasma and lung lymph increased significantly after the combined injury. These changes were attenuated by posttreatment with LAM-(1–3). These results suggest that the changes in pulmonary transvascular fluid flux result from injury of lung endothelium by polymorphonuclear leukocytes. In conclusion, posttreatment with the antibody for L-selectin improved lung lymph flow and permeability index. L-selectin appears to be principally involved in the increased pulmonary transvascular fluid flux observed with burn/smoke insult. L-selectin may be a useful target in the treatment of acute lung injury after burn and smoke inhalation.

scholarly journals Blood–Brain Barrier Dysfunction After Smoke Inhalation Injury, With and Without Skin Burn

Shock ◽  
2019 ◽  
Vol 51 (5) ◽  
pp. 634-649 ◽  
Author(s):  
Anita C. Randolph ◽  
Satoshi Fukuda ◽  
Koji Ihara ◽  
Perenlei Enkhbaatar ◽  
Maria-Adelaide Micci
Keyword(s):  
Blood Brain Barrier ◽  
Inhalation Injury ◽  
Smoke Inhalation ◽  
Brain Barrier ◽  
Barrier Dysfunction ◽  
Skin Burn ◽  
Smoke Inhalation Injury ◽  
Blood Brain

scholarly journals Smoke inhalation injury

BJA Education ◽  
2015 ◽  
Vol 15 (3) ◽  
pp. 143-148 ◽  
Author(s):  
Preea Gill ◽  
Rebecca V Martin
Keyword(s):  
Inhalation Injury ◽  
Smoke Inhalation ◽  
Smoke Inhalation Injury
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