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3. Burn Resuscitation Practices in North America

Author

Greenhalgh, David G, Cartotto, Robert, Taylor, Sandra L, Fine, Jeffrey R, Lewis, Giavonni M, Smith, David J, Marano, Michael A, Gibson, Angela, Wibbenmeyer, Lucy A, Holmes, James H, Rizzo, Julie A, Foster, Kevin N, Khandelwal, Anjay, Fischer, Sarah, Hemmila, Mark R, Hill, David, Aballay, Ariel M, Tredget, Edward E, Goverman, Jeremy, Phelan, Herbert, Jimenez, Carlos J, Baldea, Anthony, and Sood, Rajiv

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Physical Injury - Accidents and Adverse Effects, Humans, Isotonic Solutions, Fluid Therapy, Prospective Studies, Retrospective Studies, Treatment Outcome, Crystalloid Solutions, Albumins, North America, albumin, burns, crystalloid, resuscitation, Medical and Health Sciences, Surgery, Clinical sciences
Abstract

ObjectivesABRUPT was a prospective, noninterventional, observational study of resuscitation practices at 21 burn centers. The primary goal was to examine burn resuscitation with albumin or crystalloids alone, to design a future prospective randomized trial.Summary background dataNo modern prospective study has determined whether to use colloids or crystalloids for acute burn resuscitation.MethodsPatients ≥18 years with burns ≥ 20% total body surface area (TBSA) had hourly documentation of resuscitation parameters for 48 hours. Patients received either crystalloids alone or had albumin supplemented to crystalloid based on center protocols.ResultsOf 379 enrollees, two-thirds (253) were resuscitated with albumin and one-third (126) were resuscitated with crystalloid alone. Albumin patients received more total fluid than Crystalloid patients (5.2 ± 2.3 vs 3.7 ± 1.7 mL/kg/% TBSA burn/24 hours), but patients in the Albumin Group were older, had larger burns, higher admission Sequential Organ Failure Assessment (SOFA) scores, and more inhalation injury. Albumin lowered the in-to-out (I/O) ratio and was started ≤12 hours in patients with the highest initial fluid requirements, given >12 hours with intermediate requirements, and avoided in patients who responded to crystalloid alone.ConclusionsAlbumin use is associated with older age, larger and deeper burns, and more severe organ dysfunction at presentation. Albumin supplementation is started when initial crystalloid rates are above expected targets and improves the I/O ratio. The fluid received in the first 24 hours was at or above the Parkland Formula estimate.

Published
2023

15. Clinical Assessment of Low Calcium In traUMa (CALCIUM)

Author

Mendez, Jessica, Jonas, Rachelle B., Barry, Lauran, Urban, Shane, Cheng, Alex C., Aden, James K., Bynum, James, Fisher, Andrew D., Shackelford, Stacy A., Jenkins, Donald H., Gurney, Jennifer M., Bebarta, Vikhyat S., Cap, Andrew P., Rizzo, Julie A., Wright, Franklin L., Nicholson, Susannah E., and Schauer, Steven G.

Subjects
United States. Department of Defense, University of Texas, Vanderbilt University. Medical Center, Research, Risk factors, Health aspects, Mortality -- Colorado -- Texas, Medical research -- Health aspects, Blood transfusion -- Research -- Health aspects, Biological products -- Research -- Health aspects, Medicine, Experimental -- Health aspects
Abstract

INTRODUCTION Hypocalcemia occurs frequently in critically ill patients including severely injured trauma patients. (1,2) Hypocalcemia is associated with massive resuscitation with blood products and chelation of serum calcium by the [...]

Published
2023

16. An Assessment of Casualties Undergoing Delayed Surgical Intervention in the Combat Setting

Author

Arnold, Jacob L., MacDonald, Austin G., Rizzo, Julie A., Baker, Jay B., April, Michael D., and Schauer, Steven G.

Subjects
United States. Department of Defense -- Analysis, Military aspects, Analysis, Therapeutics -- Military aspects -- Analysis, Head injuries -- Analysis -- Military aspects, Biological products -- Military aspects -- Analysis, Homeopathy -- Materia medica and therapeutics
Abstract

INTRODUCTION Background: Over the past 22 years of war in Afghanistan, Iraq, Syria, and the African continent, the US military has made great strides in resuscitation of critically wounded casualties. [...]

Published
2023

17. A Narrative Review of Traumatic Pneumothorax Diagnoses and Management

Author

Anderson, David E., Kocik, Veronica I., Rizzo, Julie A., Fisher, Andrew D., Mould-Millman, Nee-Kofi, April, Michael D., and Schauer, Steven G.

Subjects
Management, Care and treatment, Development and progression, Health aspects, Company business management, Mortality -- Texas, Diagnostic imaging -- Health aspects, Pneumothorax -- Care and treatment -- Development and progression
Abstract

INTRODUCTION One of the most prevalent complications of any thoracic trauma, a pneumothorax (PTX), is commonly encountered in emergency settings with a 40%-50% occurrence in all fatal cases. (1,2) Traumatic [...]

Published
2023

21. Understanding the burden of traumatic injuries at the United States–Mexico border: A scoping review of the literature

Author

Keller, Benjamin A., Skubic, Jeffrey, Betancourt-Garcia, Monica, Ignacio, Romeo C., Radowsky, Jason S., Tyroch, Alan H., Lascano, Carlos Palacio, Joseph, Bellal, Stewart, Collin, Moore, Forrest O., Costantini, Todd W., Rizzo, Julie A., Paul, Jasmeet S., Galindo, Roger M., Silva, Aaron, Coimbra, Raul, and Berndtson, Allison E.

Published
2023
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23. Strength and Cardiorespiratory Exercise Rehabilitation for Severely Burned Patients During Intensive Care Units: A Survey of Practice.

Author

Cambiaso-Daniel, Janos, Parry, Ingrid, Rivas, Eric, Kemp-Offenberg, Jennifer, Sen, Soman, Rizzo, Julie, Serghiou, Michael, Kowalske, Karen, Wolf, Steven, Herndon, David, and Suman, Oscar

Subjects
Burn Units, Burns, California, Exercise Therapy, Female, Humans, Intensive Care Units, Male, Resistance Training, Surveys and Questionnaires, Texas
Abstract

Minimizing the deconditioning of burn injury through early rehabilitation programs (RP) in the intensive care unit (ICU) is of importance for improving the recovery time. The aim of this study was to assess current standard of care (SOC) for early ICU exercise programs in major burn centers. We designed a survey investigating exercise RP on the ICU for burn patients with >30% total burned surface area. The survey was composed of 23 questions and submitted electronically via SurveyMonkey® to six major (pediatric and adult) burn centers in Texas and California. All centers responded and reported exercise as part of their RP on the ICU. The characteristics of exercises implemented were not uniform. All centers reported to perform resistive and aerobic exercises but only 83% reported isotonic and isometric exercises. Determination of intensity of exercise varied with 50% of centers using patient tolerance and 17% using vital signs. Frequency of isotonic, isometric, aerobic, and resistive exercise was reported as daily by 80%, 80%, 83%, and 50% of centers, respectively. Duration for all types of exercises was extremely variable. Mobilization was used as a form of exercise by 100% of burn centers. Our results demonstrate that although early RP seem to be integral during burn survivors ICU stay, no SOC exists. Moreover, early RP are inconsistently administered and large variations exist in frequency, intensity, duration, and type of exercise. Thus, future prospective studies investigating the various components of exercise interventions are needed to establish a SOC and determine how and if early exercise benefits the burn survivor.

Published
2018

26. A phase 3, open-label, controlled, randomized, multicenter trial evaluating the efficacy and safety of StrataGraft® construct in patients with deep partial-thickness thermal burns

Author

Gibson, Angela L.F., Holmes, James H., IV, Shupp, Jeffrey W., Smith, David, Joe, Victor, Carson, Joshua, Litt, Jeffrey, Kahn, Steven, Short, Tracee, Cancio, Leopoldo, Rizzo, Julie, Carter, Jeffrey E., Foster, Kevin, Lokuta, Mary A., Comer, Allen R., Smiell, Janice M., and Allen-Hoffmann, B. Lynn

Published
2021
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28. Organ Responses and Organ Support

Author

Ainsworth, Craig R., Rizzo, Julie A., Chung, Kevin K., Jeschke, Marc G., editor, Kamolz, Lars-Peter, editor, Sjöberg, Folke, editor, and Wolf, Steven E., editor

Published
2020
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29. Characterising practice patterns of human derived, lyophilized coagulation concentrates within the trauma quality improvement program registry.

Author

Rosenthal, Chester A., Douin, David J., Cohen, Mitch J., Rizzo, Julie A., April, Michael D., and Schauer, Steven G.

Subjects
PROTHROMBIN, FIBRINOGEN, DESCRIPTIVE statistics, MEDICAL registries, HEMORRHAGE
Abstract

Objectives: We seek to describe the current practice pattern use of prothrombin complex concentrate (PCC) and fibrinogen concentrate (FC) in trauma patients. Background: Trauma‐induced coagulopathy (TIC) and endotheliopathy of trauma (EOT) contribute significantly to mortality from traumatic haemorrhage. FC, and 4‐factor PCC are potential treatments for EOT and TIC, respectively. Materials and Methods: We obtained data from the Trauma Quality Improvement Program (TQIP) registry and identified patients who received either PCC or FC using procedural codes. We used descriptive statistics to characterise practice patterns of these products. Results: There were 6 714 002 total encounters within the TQIP from 2017 to 2022, of which 10 589 received PCC and 3009 received FC. Of the recipients, there were 35 that received both products. There were 44 that received both. The median age of PCC recipients was 77 (69–84) with 19 patients <15 years of age with the youngest being 2 years of age. There was a general upward trend in the number of facilities with documented use of PCC: 155/744, 168/766, 189/764, 206/780, 234/795, and 235/816, respectively. The median age of FC recipients was 57 (32–75) with 48 patients <15 years of age with the youngest being 1 year of age. There was a minor downward trend in the number of facilities that had documented use of FC: 55, 44, 39, 32, 38 and 40. Conclusions: The administration of PCC and FC remains uncommon, although there appears to be an upward trend of PCC use. Most PCC use appeared to be for anticoagulation reversal in the setting of head trauma. Data guiding the use of these products are necessary as these products become more recognised as adjuncts to traumatic haemorrhage control. [ABSTRACT FROM AUTHOR]

Published
2024
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33. Burn Casualties

Author

Barillo, David J., Rizzo, Julie A., Broger, Kristine P., Hurd, William W., editor, and Beninati, William, editor

Published
2019
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44. 1565: A SUB-ANALYSIS OF SEVERE TRAUMATIC BRAIN INJURY PATIENTS ENROLLED IN THE SAVE-O2 RANDOMIZED TRIAL

Author

Schauer, Steven, primary, Douin, David, additional, Jackson, Conner, additional, Anderson, Erin, additional, Cwik, Jessica, additional, Steinwand, Aimee, additional, Rice, John, additional, Cheng, Alex, additional, April, Michael, additional, Mancha, Fabiola, additional, Mendez, Jessica, additional, Rizzo, Julie, additional, Bebarta, Vikhyat, additional, and Ginde, Adit, additional

Published
2023
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