Case Report: End Point Resuscitation of Severe Burn Injury with Inhalational Trauma in Intensive Care Unit Andie Muhari B, Nurita Dian, Moch Hasyim, Basuki Rachmad
Departement of Anesthesiology and Intensive Care
Dr. Hasan Sadikin Central General Hospital/Faculty of Medicine Universitas Padjadjaran, Bandung
Abstract
Severe burn injury involved wound area > 25% of total body surface area, which is often required management in Intensive Care Unit (ICU), especially if inhalation trauma is suspected. The diagnosis of inhalation trauma needs to be established immediately to avoid life-threatening airway obstruction. In severe burns, physiological changes occur involving multiple organs. Handling must involve multidisciplinary science. Coagulopathy occurs immediately after a burn, causing a microvascular reaction around the dermis which results in the expansion of the injury. Burns activate systemic responses caused by loss of skin barrier, release of vasoactive mediators from wounds and infections that follow. The result of this process is interstitial edema in organs and soft tissues. This process requires handling resuscitation that is individualized, depending on the parameters of each patient. For this reason, it is necessary to concern more about end point resuscitation target of burn injury to prevent complications due to over or under resuscitation.
Keywords: burn injury, inhalational trauma, end point resuscitation
