Organ responses and organ support

Abstract

Over the past fifty years, goal-directed resusci tation [1- 3], early burn wound excision and grafting [4 -7], and recognition of burn hypercatabol ism[8 -10] have dramatically reduced mortality rates after burn injury [11-15]. Despite this progress, end-organ dysfunction remains a threat throughout a patient’s clinical course. Recent studies approximate the incidence of multiple organ dysfunction as 40 - 60 % among patients with greater than 20 % total body surface area (TBSA) burns, with associated mortality rates from 22 -100 % [16 -19]. These mortality rates increase in proportion to the number of failed systems [19]. The link between multi-organ failure and patient mortality highlights the necessity for practitioners to cultivate an understanding of burn pathophysiology, as well as critical care princip les of organ support.