title: Adjunctive hyperbaric oxygen therapy in severe burns: Experience in Taiwan Formosa Water Park dust explosion disaster.
abstract: BACKGROUND
  Despite major advances in therapeutic strategies for the management of patients with severe burns, significant morbidity and mortality is observed. Hyperbaric oxygen therapy (HBOT) increases the supply of oxygen to burn areas. The aim of this study was to determine whether HBOT is effective in the treatment of major thermal burns.
  
  
  METHODS
  On June 27, 2015 in New Taipei, Taiwan, a mass casualty disaster occurred as fire erupted over a large crowd, injuring 499 people. Fifty-three victims (20 women and 33 men) were admitted to Tri-Service General Hospital. Thirty-eight patients underwent adjunctive HBOT (HBOT group), and 15 patients received routine burn therapy (control group). Serum procalcitonin (PCT) level, a sepsis biomarker, was measured until it reached normal levels (<0.5μg/L). The records of all patients from June 2015 to March 2016 were analyzed retrospectively. Outcome measures that were compared between the groups included the use of tracheostomy and hemodialysis, total body surface area (TBSA) and the number of skin graft operations, length of hospital stay, infection status, and mortality.
  
  
  RESULTS
  The mean age of the patients was 22.4 years, and the mean TBSA was 43%. All the patients survived and were discharged without requiring limb amputation or being permanently disabled. Patient characteristics did not differ significantly between the groups. PCT levels returned to normal significantly faster (p=0.007) in the HBOT group.
  
  
  CONCLUSIONS
  Multidisciplinary burn care combined with adjunctive HBOT improves sepsis control compared with standard treatment without HBOT. Prospective studies are required to define the role of HBOT in extensive burns.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: I-Han
authors.initials: IH
authors.lastname: Chiang
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Shyi-Gen
authors.initials: SG
authors.lastname: Chen
authors.affiliation: Hyperbaric Oxygen Therapy Center, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Kun-Lun
authors.initials: KL
authors.lastname: Huang
authors.affiliation: School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Yu-Ching
authors.initials: YC
authors.lastname: Chou
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Niann-Tzyy
authors.initials: NT
authors.lastname: Dai
authors.affiliation: Hyperbaric Oxygen Therapy Center, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC. Electronic address: kanpeng@mail.ndmctsgh.edu.tw.
authors.forename: Chung-Kan
authors.initials: CK
authors.lastname: Peng
mesh_terms: D001830:Body Surface Area; D002056:Burns / Q000150:complications / Q000628:therapy*; D002116:Calcitonin / Q000097:blood*; D004190:Disasters; D005107:Explosions; D005260:Female; D005390:Fires; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods*; D007902:Length of Stay; D008297:Male; D054527:Mass Casualty Incidents; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood* / Q000209:etiology; D016038:Skin Transplantation; D013624:Taiwan; D055815:Young Adult
chemical_list: D002116:Calcitonin
keywords: Burn; Dust explosion disaster; Hyperbaric oxygen therapy