Herndon DN et al. A comparison of conservative versus early excision. Therapies in severely burned patients. Ann Surg. 1989 May;209(5):547-52; discussion 552-3. [PMC1494069]
- single centre
- n = 85
- inclusion criteria: > 30% TBSA burn
- early excision VS topical antimicrobials + skin grafting after spontaneous eschar separation
-> mortality from burns without inhalational injury decreased by early excision
-> reduces hypermetabolic response to burns
-> reduces infection
-> improves cosmesis
Herndon DN, Hart DW, Wolf SE, Chinkes DL, Wolfe RR. Reversal of catabolism by beta-blockade after severe burns. N Engl J Med. 2001 Oct 25;345(17):1223-9. [PMID 11680441]
- n = 25
- inclusion: children, > 40% TBSA
- propanolol PO vs placebo
-> significant reduction in heart rate, resting energy expenditure
-> increased muscle-protein balance
Navar PD, Saffle JR, Warden GD. Effect of inhalation injury on fluid resuscitation requirements after thermal injury. Am J Surg. 1985 Dec;150(6):716-20. [PMID 4073365]
- n = 171
- inclusion: thermal burns covering >25% TBSA
- Parkland formulae resuscitation + additional fluids targeting a urine output 30-50mL/hr
- 51 patients had an inhalational injury
-> these patients required 50% more fluid
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.