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Burn Definition
Burns are results of tissue injury caused by exposure to heat, chemical radiation or electricity
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burn degrees
- Superficial
- Superficial partial thickness
- Deep partial thickness
- Full thickness reaches the muscle
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measure of the severity of skin burn
TBSA
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Critically ill burned patients are characterized by
- Strong oxidative stress
- Intense inflammatory response
- Hypermetabolic and catabolic response
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Fluid shift during the early phase of major burn
- Massive increase in capillary permeability
- plasma loss from the intravascular space into the extravascular compartment
- Generalized oedema
- Massive increase in fluid requirements
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Resuscitation endpoints and monitoring
- Urine output
- Heart rate
- blood pressure
- lactate
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formulas for estimating energy requirements for burn patients
- currier
- harris
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Carbohydrate limit
60%
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protein requirements
- adults 1.5–2.0 g/kg/day
- children 2.5–4.0 g/kg/day
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nutrients provided routinely to burn patients to promote wound healing.
- Glutamine
- omega-3 fatty acids
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Patients have increased micronutrients requirements due to
- Hypermetabolic
- Cutaneous exudative losses
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important vitamins
- C
- A
- E
- Copper
- selenium
- magnesium
- phosphorus
- zinc
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vitamin c requirements and effects
- collagen synthesis
- antioxidant effect
- daily intake of 1–2 g
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Vitamins A and E effect
tissue repair
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Non-nutritional management of hypermetabolism
- 28-30 C
- Early excision and coverage of deep burn wound
- agents stimulating protein synthesis (nonselective beta-blockers, oxandrolone)
- Pain control
- exercise therapy program