Burns: Pathophysiology of Systemic Complications and Current Management

As a result of many years of research, the intricate cellular mechanisms of burn injury are slowly becoming clear. Yet, knowledge of these cellular mechanisms and a multitude of resulting studies have often failed to translate into improved clinical treatment for burn injuries. Perhaps the most valuable information to date is the years of clinical experience and observations in the management and treatment of patients, which has contributed to a gradual improvement in reported outcomes of mortality. This review provides a discussion of the cellular mechanisms and pathways involved in burn injury, resultant systemic effects on organ systems, current management and treatment, and potential therapies that we may see implemented in the future.

• Publication year

  2016

• Venue

  Journal of Burn Care & Research

• Publication date

  2016-12-22

• Fields of study

  Medicine

• Identifiers
  DOI 10.1097/BCR.0000000000000355PMID 27183443PMCID 5214064
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Books Received Pocket Atlas of Sectional Anatomy — Volume I : Head and Neck : 4th Edition Copyright © North American Neuro- O phthalmology Society . Unauthorized reproduction of this article is prohibited .

  2018cited by this paper
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  2016cited by this paper
• Intra-abdominal hypertension and abdominal compartment syndrome in burns, obesity, pregnancy, and general medicine.

  2015cited by this paper
• Allogeneic mesenchymal stem cells, but not culture modified monocytes, improve burn wound healing.

  2015cited by this paper
• Fictitious Hyperglycemia: Point-of-Care Glucose Measurement Is Inaccurate During High-Dose Vitamin C Infusion for Burn Shock Resuscitation

  2015cited by this paper
• Acute and Perioperative Care of the Burn-injured Patient

  2015cited by this paper
• [Influence of lipoic acid on the level of TNF-alpha in spleen homogenates].

  2014cited by this paper
• Uncoupled skeletal muscle mitochondria contribute to hypermetabolism in severely burned adults.

  2014cited by this paper
• Ghrelin Therapy Improves Survival after Whole-Body Ionizing Irradiation or Combined with Burn or Wound: Amelioration of Leukocytopenia, Thrombocytopenia, Splenomegaly, and Bone Marrow Injury

  2014cited by this paper
• Physiological effect and therapeutic application of alpha lipoic acid.

  2014cited by this paper
• Burn intensive care.

  2014influential reference
• Mouse Mast Cell Proteases 4 and 5 Mediate Epidermal Injury through Disruption of Tight Junctions

  2014cited by this paper
• Inhalation injury in burn patients: establishing the link between diagnosis and prognosis.

  2014cited by this paper
• Local thermal injury induces general endothelial cell contraction through p38 MAP kinase activation

  2014cited by this paper
• Development of mast cells and importance of their tryptase and chymase serine proteases in inflammation and wound healing.

  2014influential reference
• A systematic review on intra-abdominal pressure in severely burned patients.

  2014cited by this paper
• Interventions for preventing critical illness polyneuropathy and critical illness myopathy.

  2014cited by this paper
• Role of α-lipoic acid in LPS/d-GalN induced fulminant hepatic failure in mice: studies on oxidative stress, inflammation and apoptosis.

  2014cited by this paper
• Heparin/N-acetylcysteine: an adjuvant in the management of burn inhalation injury: a study of different doses.

  2014cited by this paper
• Topical N-Acetylcysteine Accelerates Wound Healing in Vitro and in Vivo via the PKC/Stat3 Pathway

  2014influential reference
• Oxandrolone use in adult burn patients. Systematic review and meta-analysis.

  2014influential reference
• Melatonin inhibits thermal injury–induced hyperpermeability in microvascular endothelial cells

  2014cited by this paper
• Protective Efficacy of Alpha-lipoic Acid against AflatoxinB1-induced Oxidative Damage in the Liver

  2014cited by this paper
• Lipid mediators in immune dysfunction after severe inflammation

  2014influential reference
• Treatment of Patients With Severe Burns—Costs and Health-Related Quality of Life Outcome

  2014cited by this paper
• Title efficacy of phosphodiesterase 5 inhibitor on distant burn-induced muscle autophagy, microcirculation, and survival rate.

  2013cited by this paper
• Concise Review: Tissue‐Engineered Skin and Nerve Regeneration in Burn Treatment

  2013cited by this paper
• Effect of Acute Thermal Injury in Status of Serum Vitamins, Inflammatory Markers, and Oxidative Stress Markers: Preliminary Data

  2013influential reference
• Treatment of Patients With Severe Burns—Costs and Health-Related Quality of Life Outcome

  2013cited by this paper
• Protective effects of alpha-lipoic Acid on oleic Acid-induced acute lung injury in rats.

  2013cited by this paper
• Trajectories to death in patients with burn injury

  2013cited by this paper
• Alternative erythropoietin-mediated signaling prevents secondary microvascular thrombosis and inflammation within cutaneous burns

  2013cited by this paper
• Clinical review: The critical care management of the burn patient

  2013cited by this paper
• Alpha-lipoic acid ameliorates oxidative stress by increasing aldehyde dehydrogenase-2 activity in patients with acute coronary syndrome.

  2013cited by this paper
• Alpha lipoic acid attenuates inflammatory response during extracorporeal circulation

  2013cited by this paper
• Ulinastatin inhibits unilateral ureteral obstruction-induced renal interstitial fibrosis in rats via transforming growth factor β (TGF-β)/Smad signalling pathways.

  2013cited by this paper
• The impact of severe burns on skeletal muscle mitochondrial function.

  2013influential reference
• Umbilical Cord Mesenchymal Stem Cell Transplantation Ameliorates Burn-Induced Acute Kidney Injury in Rats

  2013cited by this paper
• Is propranolol of benefit in pediatric burn patients?

  2013cited by this paper
• Predicting length of stay in thermal burns: a systematic review of prognostic factors.

  2013cited by this paper
• Extracorporeal membrane oxygenation in burn and smoke inhalation injury.

  2013cited by this paper
• Melatonin Protection against Burn-Induced Hepatic Injury by Down-Regulation and Nuclear Factor Kappa B Activation

  2012cited by this paper
• BET 3: Vitamin C in severe burns

  2012influential reference
• The Acute Kidney Injury Network (AKIN) Criteria Applied in Burns

  2012influential reference
• Role of the PPAR-α agonist fenofibrate in severe pediatric burn.

  2012cited by this paper
• Mast Cells and Wound Healing

  2012cited by this paper
• Extracorporeal membrane oxygenation in burn and smoke inhalation injury

  2012influential reference
• Severe burn injury, burn shock, and smoke inhalation injury in small animals. Part 1: burn classification and pathophysiology.

  2012influential reference
• Stem Cells, Including a Population of Very Small Embryonic-Like Stem Cells, are Mobilized Into Peripheral Blood in Patients After Skin Burn Injury

  2012cited by this paper
• Effect of N-acetylcysteine treatment on oxidative stress and inflammation after severe burn.

  2012cited by this paper
• Severe burn injury, burn shock, and smoke inhalation injury in small animals. Part 2: diagnosis, therapy, complications, and prognosis.

  2012influential reference
• Burns: an update on current pharmacotherapy

  2012influential reference
• What, how, and how much should patients with burns be fed?

  2011influential reference
• [Burn: An inflammatory process].

  2011cited by this paper
• Prognostic scoring systems in burns: a review.

  2011cited by this paper
• Burns: where are we standing with propranolol, oxandrolone, recombinant human growth hormone, and the new incretin analogs?

  2011cited by this paper
• Cell therapy of burns

  2011influential reference
• Nutrition in burns: Galveston contributions.

  2011influential reference
• Effect of antioxidants on the incidence of wound infection in burn patients.

  2010influential reference
• Early fluid resuscitation with hyperoncotic hydroxyethyl starch 200/0.5 (10%) in severe burn injury

  2010cited by this paper
• Predicting Prognosis in Thermal Burns With Associated Inhalational Injury: A Systematic Review of Prognostic Factors in Adult Burn Victims

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  2010influential reference
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  2010influential reference
• Burn resuscitation: the results of the ISBI/ABA survey.

  2010cited by this paper
• Critical Illness Polyneuropathy in Patients With Major Burn Injuries

  2010cited by this paper
• The Hepatic Response to Thermal Injury: Is the Liver Important for Postburn Outcomes?

  2009influential reference
• Intraabdominal Hypertension and the Abdominal Compartment Syndrome in Burn Patients

  2009cited by this paper
• The hypermetabolic response to burn injury and interventions to modify this response.

  2009influential reference
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  2009influential reference
• Vitamin C and Smoke Inhalation Injury

  2009cited by this paper
• American Burn Association Practice Guidelines Burn Shock Resuscitation

  2009cited by this paper
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  2009cited by this paper
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  2008influential reference
• Ghrelin improves burn-induced multiple organ injury by depressing neutrophil infiltration and the release of pro-inflammatory cytokines.

  2008cited by this paper
• [Intraabdominal hypertension and abdominal compartment syndrome].

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• Copyright

  2005cited by this paper
• Macrophages and post-burn immune dysfunction.

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• Free radicals and lipid peroxidation mediated injury in burn trauma: the role of antioxidant therapy.

  2003influential reference
• Role of mast cells in the pathogenesis of postburn inflammatory response: reactive oxygen species as mast cell stimulators.

  2000influential reference
• Effects of N-acetylcysteine on lung glutathione levels in rats after burn injury.

  1997influential reference
• Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Management of Burn Injuries – Recent Developments in Resuscitation, Infection Control and Outcomes Research

  year unknowninfluential reference

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