Delineating Gastrointestinal Dysfunction Variants in Severe Burn Injury Cases: A Retrospective Case Series with Literature Review
Background: Severe burns can significantly impact various organ systems, including the gastrointestinal (GI) system. GI complications are frequently observed in patients with over 20% total body surface area (TBSA) burn. Objectives: This case series delves into the intricate phenomenology of post-b...
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| Format: | Article |
| Language: | English |
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Arizona Thoracic Society
2024-03-01
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| Series: | Southwest Journal of Pulmonary and Critical Care |
| Subjects: | |
| Online Access: | https://www.swjpcc.com/critical-care/2024/3/20/delineating-gastrointestinal-dysfunction-variants-in-severe.html |
| _version_ | 1797254415817637888 |
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| author | Sriharsha Rapaka MD Priyankar Kumar Datta MD, DNB, DM Shashikant Sharma MD, DM |
| author_facet | Sriharsha Rapaka MD Priyankar Kumar Datta MD, DNB, DM Shashikant Sharma MD, DM |
| author_sort | Sriharsha Rapaka MD |
| collection | DOAJ |
| description | Background: Severe burns can significantly impact various organ systems, including the gastrointestinal (GI) system. GI complications are frequently observed in patients with over 20% total body surface area (TBSA) burn.
Objectives: This case series delves into the intricate phenomenology of post-burn GI dysfunction, challenging conventional cause-and-effect paradigms. Our aim is to discern, comprehend, and explore variables influencing positive and negative outcomes, laying the foundation for further research given the current heterogeneity in the literature.
Methods: Severe burn patients with GI dysfunction identified between April 1, 2022, and July 31, 2022, from the institutional database are included in this retrospective case-series, and comparisons were made across baseline and treatment conditions across participants. Data were collected on demographics, burn characteristics, complications, and treatment outcomes.
Results: We analysed 12 patients with severe burns and GI dysfunction and categorized them into two patterns: Pattern A, characterised by early onset symptoms, gastric and small bowel dilatation, and a relatively benign course with high recovery rates was observed in 6 patients; and Pattern B, characterised by late-onset symptoms, colonic dilatation, shock, and a high mortality rate due to megacolon was seen in 6 patients.
Conclusion: The post-burn GI dysfunction observed in our study is a complex interplay of multiple factors. Adequate fluid resuscitation, timely excision of necrotic tissue, staged food ingestion, specific nutrient administration, and appropriate use of antibiotics and judicious use of selective digestive decontamination (SDD) are essential strategies to prevent and treat this syndrome. |
| first_indexed | 2024-04-24T21:49:36Z |
| format | Article |
| id | doaj.art-004d76c0a0c84f31affcbf7c95e3441a |
| institution | Directory Open Access Journal |
| issn | 2160-6773 |
| language | English |
| last_indexed | 2024-04-24T21:49:36Z |
| publishDate | 2024-03-01 |
| publisher | Arizona Thoracic Society |
| record_format | Article |
| series | Southwest Journal of Pulmonary and Critical Care |
| spelling | doaj.art-004d76c0a0c84f31affcbf7c95e3441a2024-03-20T14:23:44ZengArizona Thoracic SocietySouthwest Journal of Pulmonary and Critical Care2160-67732024-03-01283404810.13175/swjpccs006-24Delineating Gastrointestinal Dysfunction Variants in Severe Burn Injury Cases: A Retrospective Case Series with Literature ReviewSriharsha Rapaka MD 0Priyankar Kumar Datta MD, DNB, DM 1Shashikant Sharma MD, DM2Intensive Care Medicine, St John of God Healthcare, Victoria, AustraliaAnaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, IndiaAnaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, IndiaBackground: Severe burns can significantly impact various organ systems, including the gastrointestinal (GI) system. GI complications are frequently observed in patients with over 20% total body surface area (TBSA) burn. Objectives: This case series delves into the intricate phenomenology of post-burn GI dysfunction, challenging conventional cause-and-effect paradigms. Our aim is to discern, comprehend, and explore variables influencing positive and negative outcomes, laying the foundation for further research given the current heterogeneity in the literature. Methods: Severe burn patients with GI dysfunction identified between April 1, 2022, and July 31, 2022, from the institutional database are included in this retrospective case-series, and comparisons were made across baseline and treatment conditions across participants. Data were collected on demographics, burn characteristics, complications, and treatment outcomes. Results: We analysed 12 patients with severe burns and GI dysfunction and categorized them into two patterns: Pattern A, characterised by early onset symptoms, gastric and small bowel dilatation, and a relatively benign course with high recovery rates was observed in 6 patients; and Pattern B, characterised by late-onset symptoms, colonic dilatation, shock, and a high mortality rate due to megacolon was seen in 6 patients. Conclusion: The post-burn GI dysfunction observed in our study is a complex interplay of multiple factors. Adequate fluid resuscitation, timely excision of necrotic tissue, staged food ingestion, specific nutrient administration, and appropriate use of antibiotics and judicious use of selective digestive decontamination (SDD) are essential strategies to prevent and treat this syndrome. https://www.swjpcc.com/critical-care/2024/3/20/delineating-gastrointestinal-dysfunction-variants-in-severe.htmlburnsgi dysfunctiondiarrheacolonic dilatationshockmortality rateclassificationabdominal x-raycase seriesreview |
| spellingShingle | Sriharsha Rapaka MD Priyankar Kumar Datta MD, DNB, DM Shashikant Sharma MD, DM Delineating Gastrointestinal Dysfunction Variants in Severe Burn Injury Cases: A Retrospective Case Series with Literature Review Southwest Journal of Pulmonary and Critical Care burns gi dysfunction diarrhea colonic dilatation shock mortality rate classification abdominal x-ray case series review |
| title | Delineating Gastrointestinal Dysfunction Variants in Severe Burn Injury Cases: A Retrospective Case Series with Literature Review |
| title_full | Delineating Gastrointestinal Dysfunction Variants in Severe Burn Injury Cases: A Retrospective Case Series with Literature Review |
| title_fullStr | Delineating Gastrointestinal Dysfunction Variants in Severe Burn Injury Cases: A Retrospective Case Series with Literature Review |
| title_full_unstemmed | Delineating Gastrointestinal Dysfunction Variants in Severe Burn Injury Cases: A Retrospective Case Series with Literature Review |
| title_short | Delineating Gastrointestinal Dysfunction Variants in Severe Burn Injury Cases: A Retrospective Case Series with Literature Review |
| title_sort | delineating gastrointestinal dysfunction variants in severe burn injury cases a retrospective case series with literature review |
| topic | burns gi dysfunction diarrhea colonic dilatation shock mortality rate classification abdominal x-ray case series review |
| url | https://www.swjpcc.com/critical-care/2024/3/20/delineating-gastrointestinal-dysfunction-variants-in-severe.html |
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