| Acute respiratory failure that complicates the resuscitation of pediatric patients with scald injuries. | |
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MedLine Citation:
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PMID: 10501327 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Respiratory failure that requires endotracheal intubation is an uncommon but potentially fatal complication of scald burns in children. Because scalds are rarely associated with a direct pulmonary injury, the pathophysiology of respiratory failure is unclear. A possible mechanism may be upper airway edema, diminished pulmonary compliance secondary to fluid resuscitation, or both. To identify an at-risk population for intubation after a scald injury, the hospital courses of 174 consecutive patients under the age of 14 years who were admitted after a scald injury to a single burn center during a 6-year period were examined. Seven of these patients (4%) required endotracheal intubation. No patient older than 2.8 years or who had a scald injury that covered less than 19% of the total body surface area required intubation. Patients who required intubation were younger (mean age, 1.4 vs. 2.8 years, P<.001), had a larger mean burn size (29.9% vs. 12.3% total body surface area, P<.001), and required more fluid resuscitation (7.66 vs. 4.07 cc/kg per percentage of total body surface area burned, P<.001) than patients who did not require intubation. Examination of the adequacy of resuscitation revealed that the intubated patients had an average hourly urine output of 0.84 cc/kg during the first 24 hours, suggesting that resuscitation was not excessive. Multivariate analysis demonstrated that both larger burn size (P = .041) and younger age (P = .049) were independent predictors of the need for intubation. Young patients with large body surface area burns that required large volumes of resuscitation comprise an at-risk group for respiratory failure after a scald injury. Increased vigilance is merited during the resuscitation of these patients. |
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Authors:
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A L Zak; D T Harrington; D J Barillo; D F Lawlor; K Z Shirani; C W Goodwin |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of burn care & rehabilitation Volume: 20 ISSN: 0273-8481 ISO Abbreviation: J Burn Care Rehabil Publication Date: 1999 Sep-Oct |
Date Detail:
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Created Date: 1999-10-28 Completed Date: 1999-10-28 Revised Date: 2006-08-15 |
Medline Journal Info:
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Nlm Unique ID: 8110188 Medline TA: J Burn Care Rehabil Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 391-9 Citation Subset: IM |
Affiliation:
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US Army Institute of Surgical Research, Fort Sam Houston, Texas 78234, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Body Surface Area Burns / complications* Child Child, Preschool Female Fluid Therapy Humans Intubation, Intratracheal* Male Respiratory Insufficiency / epidemiology, etiology*, therapy Resuscitation Retrospective Studies Risk Factors |
| Comments/Corrections | |
Comment In:
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J Burn Care Rehabil. 2000 May-Jun;21(3):289-90
[PMID:
10850914
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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