title: Characteristics of and strategies for patients with severe burn-blast combined injury.
abstract: BACKGROUND
  Severe burn-blast combined injury is a great challenge to medical teams for its high mortality. The aim of this study was to elucidate the clinical characteristics of the injury and to present our clinical experiences on the treatment of such cases.
  
  
  METHODS
  Five patients with severe burn-blast combined injuries were admitted to our hospital 77 hours post-injury on June 7, 2005. The burn extent ranged from 80% to 97% (89.6% +/- 7.2%) of TBSA (full-thickness burns 75% - 92% (83.4% +/- 7.3%)). All the patients were diagnosed as having blast injury and moderate or severe inhalation injury. Functions of the heart, liver, kidney, lung, pancreas and coagulation were observed. Autopsy samples of the heart, liver, and lungs were taken from the deceased. Comprehensive measures were taken during the treatment, including protection of organ dys function, use of antibiotics, early anticoagulant treatment, early closure of burn wounds, etc. All the data were analyzed statistically with t test.
  
  
  RESULTS
  One patient died of septic shock 23 hours after admission (four days after injury), the others survived. Dysfunction of the heart, liver, lungs, pancreas, and coagulation were found in all the patients on admission, and the functions were ameliorated after appropriate treatments.
  
  
  CONCLUSIONS
  Burn-blast combined injury may cause multiple organ dysfunctions, especially coagulopathy. Proper judgment of patients' condition, energetic anticoagulant treatment, early closure of burn wounds, rational use of antibiotics, nutritional support, intensive insulin treatment, timely and effective support and protection of organ function are the most important contributory factors in successful treatment of burn-blast combined injuries.
authors.affiliation: Burns Institute, First Hospital Affiliated to the General Hospital of People's Liberation Army, Beijing 100037, China. cjk304@sohu.com
authors.forename: Jia-ke
authors.initials: JK
authors.lastname: Chai
authors.forename: Zhi-yong
authors.initials: ZY
authors.lastname: Sheng
authors.forename: Jiang-yang
authors.initials: JY
authors.lastname: Lu
authors.forename: Zhong-guang
authors.initials: ZG
authors.lastname: Wen
authors.forename: Hong-ming
authors.initials: HM
authors.lastname: Yang
authors.forename: Xiao-ming
authors.initials: XM
authors.lastname: Jia
authors.forename: Li-gen
authors.initials: LG
authors.lastname: Li
authors.forename: Wei-hong
authors.initials: WH
authors.lastname: Cao
authors.forename: Dai-feng
authors.initials: DF
authors.lastname: Hao
authors.forename: Chuan-an
authors.initials: CA
authors.lastname: Shen
authors.forename: Xiao-ye
authors.initials: XY
authors.lastname: Tuo
authors.forename: Li-ming
authors.initials: LM
authors.lastname: Liang
authors.forename: Shu-jun
authors.initials: SJ
authors.lastname: Wang
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001753:Blast Injuries / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D002056:Burns / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D044623:Nutrition Therapy; D011613:Psychotherapy; D012119:Respiration
chemical_list: D000900:Anti-Bacterial Agents