The Physiologic Basis of Burn Shock and the Need for Aggressive Fluid Resuscitation.
Burn trauma in the current age of medical care still portends a 3% to 8% mortality. Of patients who die from their burn injuries, 58% of deaths occur in the first 72 hours after injury, indicating death from the initial burn shock is still a major cause of burn mortality. Significant thermal injury incites an inflammatory response, which distinguishes burns from other trauma. This article focuses on the current understanding of the pathophysiology of burn shock, the inflammatory response, and the direction of research and targeted therapies to improve resuscitation, morbidity, and mortality.
Department of Trauma, Surgical Critical Care and Emergency General Surgery, Vanderbilt University Medical Center, 1211 21st Avenue South, MAB 404, Nashville, TN 37212, USA. Electronic address: Lisa.Rae@vanderbilt.edu.
Lisa
L
Rae
Swedish Hospital, 601 E. Hampden Avenue, Englewood, CO 80113, USA.
Philip
P
Fidler
UW Burn Center, 325 9th Avenue, Seattle, WA 98104, USA.
Nicole
N
Gibran
D001777:Blood Coagulation; D002056:Burns / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D016207:Cytokines / Q000097:blood; D004487:Edema / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D005440:Fluid Therapy; D006632:Histamine / Q000378:metabolism; D006801:Humans; D020896:Hypovolemia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D007249:Inflammation / Q000097:blood / Q000209:etiology; D009102:Multiple Organ Failure / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D009569:Nitric Oxide / Q000378:metabolism; D018384:Oxidative Stress; D012151:Resuscitation; D012769:Shock / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*
D016207:Cytokines; D009569:Nitric Oxide; D006632:Histamine
Burn; Edema; Hypovolemia; Inflammation; Resuscitation; SIRS; Shock; Thermal injury