title: Advances in burn care.
abstract: OBJECTIVE
  This article reviews and critiques new developments in the critical care of burn patients.
  
  
  RESULTS
  The practice of restrictive transfusion is slowly gaining traction. Abdominal compartment syndrome is associated with resuscitation volumes of 300 ml/kg per 24 h, and percutaneous decompression may be a treatment option. Adrenal insufficiency is common, but whom and when to treat are unclear. Imaging or noninvasive monitoring may confirm renal perfusion before urine output, and the concept of permissive hypovolemia should be explored. There is progress in the laboratory in smoke inhalation and myocardial depression, but no human translation. Antibiotic pharmacokinetics in large burns are unpredictable, and so aminoglycosides (measurable concentrations) are not obsolete. Selective digestive decontamination remains controversial. Nutritional predictions by formula are inaccurate. Oxandrolone is safe and effective in promoting anabolism in large burns. Deep venous thrombosis prophylaxis remains guided only by expert opinion. Females fare worse than male patients after burns.
  
  
  CONCLUSIONS
  The application of the scientific method to burn care is improving slowly. Randomized controlled trials are becoming more common. There is a need for translation of excellent animal work to the human arena.
authors.affiliation: Department of Surgery, University of Miami/Miller School of Medicine, Miami, Florida 33101, USA. nnamias@miami.edu
authors.forename: Nicholas
authors.initials: N
authors.lastname: Namias
mesh_terms: D002056:Burns / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D005791:Patient Care / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D014481:United States