Vaughn Lindsay, Beckel Nicole, Walters Patricia
New England Animal Medical Center, West Bridgewater, MA 02379, USA.
J Vet Emerg Crit Care (San Antonio). 2012 Apr;22(2):187-200. doi: 10.1111/j.1476-4431.2012.00728.x.
To review the evaluation and treatment of patients suffering from severe burn injury (SBI), burn shock, and smoke inhalation injury. Potential complications and prognosis associated with SBI are also discussed.
Diagnosis of burn injury and burn shock is based on patient history and clinical presentation. Superficial burn wounds may not be readily apparent for the first 48 h whereas more severe wounds will be evident at presentation. Patients are diagnosed with local or SBI by estimating total body surface area involved using the 'Rule of Nines' or the Lund-Browder chart adapted from the human literature.
Patients suffering from SBI require immediate and aggressive fluid therapy. Burn wounds require prompt cooling to prevent progressive tissue damage. Due to significant pain associated with burn wounds and therapeutic procedures, multimodal analgesia is recommended. Daily wound management including hydrotherapy, topical medications, and early wound excision and grafting is necessary with SBI.
There are numerous complications associated with SBI. The most common complications include infections, hypothermia, intra-abdominal hypertension, and abdominal compartment syndrome.
The prognosis of SBI in domestic animals is unknown. Based on information derived from human literature, patients with SBI and concomitant smoke inhalation likely have a worse prognosis than those with SBI or smoke inhalation alone.
回顾重度烧伤(SBI)、烧伤休克和吸入性损伤患者的评估与治疗。还讨论了与SBI相关的潜在并发症和预后。
烧伤和烧伤休克的诊断基于患者病史和临床表现。浅表烧伤创面在最初48小时可能不明显,而更严重的创面在就诊时会很明显。通过使用“九分法”或根据人类文献改编的伦德-布劳德图表估计烧伤总面积,来诊断患者是局部烧伤还是SBI。
SBI患者需要立即进行积极的液体治疗。烧伤创面需要迅速降温以防止组织进一步损伤。由于烧伤创面和治疗过程会带来剧痛,建议采用多模式镇痛。对于SBI患者,每日伤口处理包括水疗、局部用药以及早期伤口切除和植皮是必要的。
SBI有许多相关并发症。最常见的并发症包括感染、体温过低、腹腔内高压和腹腔间隔室综合征。
家畜SBI的预后尚不清楚。根据从人类文献中获得的信息,伴有吸入性损伤 的SBI患者的预后可能比单纯SBI或单纯吸入性损伤患者更差。