RATIONALE Hyperglycemia and insulin resistance have been shown to increase morbidity and mortality in severely burned patients, and glycemic control appears essential to improve clinical outcomes. However, to date no prospective randomized study exists that determines whether intensive insulin therapy is associated with improved post-burn morbidity and mortality. OBJECTIVES To determine wheth...

Fig. 1 Comparisons in two burned patients between the rate of catabolism ofplasma albumin and y G globulin (as glkg body weight) and the basal metabolic rate (BMR) as percentages above the expected normal value. The patient treated in the cool environment had a burned area covering 30% of the body surface, 10% being full-thickness skin loss; the patient treated in the warm environment had a bur...

Severe burn injuries give rise to an extreme state of physiological stress. No other trauma results in such an accelerated rate of tissue catabolism, loss of lean body mass, and depletion of energy and protein reserves. A heightened attention to energy needs is essential, and the significance of adequate nutritional support in the complex management of patients with major burns is very importan...

The effect of dietary vitamin E supplementation was studied in burned guinea pigs. Forty-four guinea pigs bearing a catheter gastrostomy received a 30% total body surface area full thickness flame burn and were given identical enteral diets (175 kcal/kg/day) except for the amount of vitamin E. Groups 1, 2, 3, and 4 received 0, 4 mg/kg/day (approximately equivalent to guinea pig's RDA) 20 or 100...

Burn injury has been shown to impair gut transit, but the exact mechanism remains unknown. The present study investigated whether nitric oxide synthase (NOS) and cyclooxygenase (COX) mediated changes in burn-induced colonic transit. After rats underwent 30% total body surface area burn injury, they were injected with S-methylisothiourea (SMT, selective inducible NOS inhibitor), 7-nitronidazole ...

To know the therapeutic level at one's own institute is important and contributes to improving the treatment of patients. We compared the outcomes of extensively burned patients between a Chinese hospital and a Japanese hospital in order to identify the differences in the clinical treatment of severe burn patients. Thirty-four burn patients who were admitted to the National Defense Medical Coll...

INTRODUCTION Nosocomial pneumonia is a major source of morbidity and mortality after severe burns. Burned patients suffer trace element deficiencies and depressed antioxidant and immune defences. This study aimed at determining the effect of trace element supplementation on nosocomial or intensive care unit (ICU)-acquired pneumonia. METHODS Two consecutive, randomised, double-blinded, supplem...

OBJECTIVE To assess outcome differences between locally burned civilians and military personnel burned in a distant combat zone treated in the same facility. SUMMARY BACKGROUND DATA The United States Army Institute of Surgical Research (USAISR) Burn Center serves as a referral center for civilians and is the sole center for significant burns in military personnel. We made the hypothesis that ...

Since Cuthbertson first published his important investigations, the metabolic response to trauma has been the subject of continuous study in many disciplines of medicine (1-8). An impressive body of knowledge has been accumulated with respect to changes in plasma electrolyte concentrations, urinary electrolyte excretion, body composition, and adrenocortical activity. There is general agreement ...