Enteral Resuscitation: A Field-Expedient Treatment Strategy for Burn Shock during Wartime and in Other Austere Settings
Burn injuries are a constant threat in war. Aspects of the modern battlefield increase the risk of burn injuries and pose challenges for early treatment. The initial resuscitation of a severely burn-injured patient often exceeds the resources available in front-line medical facilities. This stems mo...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-01-01
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| Series: | European Burn Journal |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2673-1991/5/1/3 |
| _version_ | 1797241418304978944 |
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| author | Ian F. Jones Kiran Nakarmi Hannah B. Wild Kwesi Nsaful Kajal Mehta Raslina Shrestha Daniel Roubik Barclay T. Stewart |
| author_facet | Ian F. Jones Kiran Nakarmi Hannah B. Wild Kwesi Nsaful Kajal Mehta Raslina Shrestha Daniel Roubik Barclay T. Stewart |
| author_sort | Ian F. Jones |
| collection | DOAJ |
| description | Burn injuries are a constant threat in war. Aspects of the modern battlefield increase the risk of burn injuries and pose challenges for early treatment. The initial resuscitation of a severely burn-injured patient often exceeds the resources available in front-line medical facilities. This stems mostly from the weight and volume of the intravenous fluids required. One promising solution to this problem is enteral resuscitation with an oral rehydration solution. In addition to being logistically easier to manage, enteral resuscitation may be able to mitigate secondary injuries to the gut related to burn shock and systemic immunoinflammatory activation. This has been previously studied in burn patients, primarily using electrolyte solutions, with promising results. Modern ORS containing sodium, potassium, and glucose in ratios that maximize gut absorption may provide additional benefits as a resuscitation strategy, both in terms of plasma volume expansion and protection of the barrier and immune functions of the gut mucosa. While enteral resuscitation is promising and should be used when other options are not available, further research is needed to refine an optimal implementation strategy. |
| first_indexed | 2024-04-24T18:23:01Z |
| format | Article |
| id | doaj.art-fa296cf2c1b843fda7e317789012c032 |
| institution | Directory Open Access Journal |
| issn | 2673-1991 |
| language | English |
| last_indexed | 2024-04-24T18:23:01Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | European Burn Journal |
| spelling | doaj.art-fa296cf2c1b843fda7e317789012c0322024-03-27T13:34:05ZengMDPI AGEuropean Burn Journal2673-19912024-01-0151233710.3390/ebj5010003Enteral Resuscitation: A Field-Expedient Treatment Strategy for Burn Shock during Wartime and in Other Austere SettingsIan F. Jones0Kiran Nakarmi1Hannah B. Wild2Kwesi Nsaful3Kajal Mehta4Raslina Shrestha5Daniel Roubik6Barclay T. Stewart7Madigan Army Medical Center, Tacoma, WA 98431, USANepal Cleft and Burn Center, Kirtipur 44600, NepalDepartment of Surgery, University of Washington, Seattle, WA 98195, USADepartment of Plastic, Reconstructive Surgery and Burns Unit, 37 Military Hospital, Accra GA008, GhanaDepartment of Surgery, University of Washington, Seattle, WA 98195, USANepal Cleft and Burn Center, Kirtipur 44600, NepalUnited States Army Medical Corps, San Antonio, TX 98234, USADepartment of Surgery, University of Washington, Seattle, WA 98195, USABurn injuries are a constant threat in war. Aspects of the modern battlefield increase the risk of burn injuries and pose challenges for early treatment. The initial resuscitation of a severely burn-injured patient often exceeds the resources available in front-line medical facilities. This stems mostly from the weight and volume of the intravenous fluids required. One promising solution to this problem is enteral resuscitation with an oral rehydration solution. In addition to being logistically easier to manage, enteral resuscitation may be able to mitigate secondary injuries to the gut related to burn shock and systemic immunoinflammatory activation. This has been previously studied in burn patients, primarily using electrolyte solutions, with promising results. Modern ORS containing sodium, potassium, and glucose in ratios that maximize gut absorption may provide additional benefits as a resuscitation strategy, both in terms of plasma volume expansion and protection of the barrier and immune functions of the gut mucosa. While enteral resuscitation is promising and should be used when other options are not available, further research is needed to refine an optimal implementation strategy.https://www.mdpi.com/2673-1991/5/1/3burnsresuscitationgut physiologyenteral resuscitationoral rehydration solutionlow- and middle-income countries |
| spellingShingle | Ian F. Jones Kiran Nakarmi Hannah B. Wild Kwesi Nsaful Kajal Mehta Raslina Shrestha Daniel Roubik Barclay T. Stewart Enteral Resuscitation: A Field-Expedient Treatment Strategy for Burn Shock during Wartime and in Other Austere Settings European Burn Journal burns resuscitation gut physiology enteral resuscitation oral rehydration solution low- and middle-income countries |
| title | Enteral Resuscitation: A Field-Expedient Treatment Strategy for Burn Shock during Wartime and in Other Austere Settings |
| title_full | Enteral Resuscitation: A Field-Expedient Treatment Strategy for Burn Shock during Wartime and in Other Austere Settings |
| title_fullStr | Enteral Resuscitation: A Field-Expedient Treatment Strategy for Burn Shock during Wartime and in Other Austere Settings |
| title_full_unstemmed | Enteral Resuscitation: A Field-Expedient Treatment Strategy for Burn Shock during Wartime and in Other Austere Settings |
| title_short | Enteral Resuscitation: A Field-Expedient Treatment Strategy for Burn Shock during Wartime and in Other Austere Settings |
| title_sort | enteral resuscitation a field expedient treatment strategy for burn shock during wartime and in other austere settings |
| topic | burns resuscitation gut physiology enteral resuscitation oral rehydration solution low- and middle-income countries |
| url | https://www.mdpi.com/2673-1991/5/1/3 |
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