Emergency Treatment of Severely Burned Pediatric Patients: Current Therapeutic Strategies

Gerd G. Gauglitz; David N. Herndon; Marc G. Jeschke

Disclosures

Pediatr Health. 2008;2(6):761-775. 

In This Article

Conclusion

Children below the age of 14 years account for approximately 50% of all emergency department-treated thermal burns. With nearly 1100 children dying of burn-related injuries in the USA every year, severe burns still represent the third most common cause of death in the pediatric patient population. However, novel concepts and techniques have been proposed and significantly improved over the past 30 years, resulting in a considerable decline in burn-related deaths and hospital admissions in the USA. The adequate and rapid institution of fluid resuscitation maintains tissue perfusion and prevents organ-system failure. Sepsis is successfully controlled by the early excision of burn wounds and topical antimicrobial agents. Patients suffering from sustained inhalation injury require additional fluid resuscitation, humidified oxygen and, occasionally, ventilatory support. Enteral tube feeding is commenced early in order to control stress ulceration, maintain intestinal mucosal integrity and provide fuel for the resulting hypermetabolic state. β-adrenergic blockade is recommended by many burn units as the most effective anticatabolic treatment. Tight glucose control has been shown to prevent several critical illness-associated complications, including blood stream infections, anemia and acute renal failure. Through the use of aggressive resuscitation, nutritional support, infection control, surgical therapy and early rehabilitation as well as multidisciplinary collaboration, better psychological and physical results can be achieved for burn children.

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