Term
| After a burn injury, how long does the increase in microvascular permeability last for in injured tissue? In noninjured tissue? |
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Definition
| 3-5 days injured, 24 hours noninjured |
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Term
| list the stages of shock following a major burn injury |
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Definition
| cardiogenic shock occurs early, followed by hypovolemic shock, and if fluid volume is resucitated septic shock ensues |
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Term
| what is the hallmark cardiovascular response to a burn injury? Why? |
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Definition
| decreased cardiac output due to the initial increase in SVR and capillary permeability (pushes fluid volume out of vasculature and reduces CO, decreased contractility (due to circulating mediators), reduced response to catecholamines, and reduced coronary blood flow |
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Term
| kids with burn injuries will have what cardiac response for weeks after their burn? |
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Definition
| HTN, due to increased catecholamines and increased renin/angio response |
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Term
| Which fluids are more successful at volume resuscitation in burn pts, crystalliods or collids? |
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Definition
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Term
| why might hypertonic solutions be avoided in the burn pt? |
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Definition
| large amounts of hypertonic fluid deplete intracellular water, produce hypernatremia, and increase incidince of renal failure |
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Term
| why might dextrose drive up a burn pts blood sugar higher than normal? |
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Definition
| within the first 24 hours, the cells develop glucose intolerance |
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Term
| do burn pts with inhalation injuries require more or less fluids? |
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Definition
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Term
| when replacing fluids in a burn pt, what 5 endpoints should drive our replacement regimen? |
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Definition
| urine output, base deficits, HR, lactate levels, Hgb/Hct |
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Term
| what is the parkland formula of fluid resuscitation in burn pts? |
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Definition
4cc LR x percent burned (expressed as a whole number, not a decimal)x kg
give half in the first 8 hours then 1/4 in the second eight and 1/4 in the third eight hours |
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Term
| what is the leading cause of long term death following a burn? |
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Definition
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Term
| what are the changes to the immune system following a burn injury? |
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Definition
| loss of skin barrier, eschar is a good medium for bacteria (gram negative presence results in high mortality), pneumonia is common, leukocytes, humoral, and cellular responses are depressed |
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Term
| Which type of burn injury causes massive muscle necrosis and results in myoglobinemia and potentially renal failure? |
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Definition
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Term
| does shock post burn increase or decrease GFR? what happens next? |
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Definition
| increase, renin/angiotensin and ADH conserve sodium and water to compensate, and ARF may develop |
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