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Anesthesiology pp 765-775 | Cite as

Anesthesia and Burns

  • Clare R. Herlihy
  • Cassandra Barry
Chapter

Abstract

Burn-injured patients present significant challenges to the medical team taking care of them. These patients present with pathophysiologic changes that affect the entire body. Burn injury creates a systemic inflammatory response that affects cardiac and pulmonary function. Burned patients require significant fluid resuscitation for management of burn shock and maintenance of organ perfusion. Complications arise from both under resuscitation and over resuscitation. In addition, patients are at risk for inhalation injury and airway compromise as well as difficult intubation. After 48 hours (h), patients begin to develop significant metabolic derangements. Hepatic and renal function are affected and patients have pharmacokinetic changes. Burn patients also have significant pain that requires a multimodal approach. Fluid titration and blood management must be carefully monitored given rapid and difficult to calculate blood loss during burn excisions. Monitoring and vascular access can be difficult in these patients. Even after the initial injury is healed these patients often present for further surgery with continued concerns regarding airway, vascular access, drug choice and positioning.

Keywords

Burn Inhalation injury Carbon monoxide Carbon monoxide Hypermetabolism Burn shock Fluid resuscitation Pain management 

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of Cincinnati Medical CenterCincinnatiUSA

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