Background: Pneumonia increases mortality in burn patients with inhalation injuries. We evaluated whether the use of High Frequency Percussive Ventilation (HFPV) in burn patients with inhalation injuries can decrease rates of Ventilator Associated Pneumonia (VAP) compared to Volume Control Ventilation (VCV).
Methods: Data were gathered from PubMed, EMBASE, Web of Science, reference lists, and hand search. For unpublished data we searched ClinicalTrials.gov and RePORTER. We included observational and Randomized Controlled Trials (RCTs) that compared rates of VAP with the use of HFPV and VCV in adult burn patients with inhalation injury. Two reviewers independently extracted data from the retrieved studies and assessed them for eligibility, methodology, and quality.
Results: 281 abstracts were reviewed, of which 4 studies (540 patients) were included. Two were observational and two were RCTs. All studies had moderate risk of bias. One study had low external validity while others had moderate external validity. The two observational studies found non-concordant results. One study found a 24% statistically significant reduction in the rates of VAP while the other found no difference. The two RCTs had small sample sizes. There was no significant difference in VAP rates between HFPV and VCV. The VCV arms of the four studies were heterogeneous. Only one study used low tidal volumes, whereas the rest used high tidal volumes in the VCV arm.
Conclusion: Evidence about decreased incidence of VAP in burn patients with inhalation injuries who are on HFPV compared to those on VCV is inconclusive. Although enhanced airway clearance by HFPV was thought to play a role in decreasing VAP in this population, high tidal volume in the VCV arms could be a confounding factor that should be eliminated in future studies before a firm conclusion can be reached. More RCTs comparing HFPV to low tidal volume VCV are needed.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.burns.2016.02.024 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Burn Patient Education in the Modern Age: A Comparative Analysis of ChatGPT and Google Performance Answering Common Questions on Burn Injury and Management.
J Burn Care Res
January 2025
Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, United States.
Patients often use Google for their medical questions. With the emergence of artificial intelligence large language models, such as ChatGPT, patients may turn to such technologies as an alternative source of medical information. This study investigates the safety, accuracy, and comprehensiveness of medical responses provided by ChatGPT in comparison to Google for common questions about burn injuries and their management.
View Article and Find Full Text PDFAllogeneic haematopoietic stem cell transplantation (alloHSCT) is safe and effective for adolescents and adults with inborn errors of immunity (IEI) with severe disease manifestations of their disease. The haematopoietic cell transplantation comorbidity index (HCT-CI) score predicts transplant survival in non-malignant diseases, including IEIs. We hypothesised that immune dysregulation pre-transplant may also influence transplant outcomes.
View Article and Find Full Text PDFNational analysis of health-related social needs among adult injury survivors.
J Trauma Acute Care Surg
January 2025
From the Department of Surgery (A.H.H., N.M.C., B.T.S.), Division of Trauma, Burn, and Critical Care Surgery, Department of Surgery (E.B., D.N., B.T.S., A.M., E.M.B., J.W.S.), and Department of Health Metrics Sciences (J.L.D., J.W.S.), Institute for Health Metrics and Evaluation, University of Washington; Psychiatry and Behavioral Sciences (D.Z.), University of Washington School of Medicine, Seattle, Washington.
Background: Despite advances in trauma care, the effects of social determinants of health continue to be a barrier to optimal health outcomes. Health-related social needs (HRSNs), now the basis of a Centers for Medicare and Medicaid Services national screening program, may contribute to poor health outcomes, inequities, and low-value care, but the impact of HRSNs among injured patients remains poorly understood at the national level.
Methods: Using data from the nationally representative 2021 Medical Expenditure Panel Survey, injured patients were matched with uninjured controls via coarsened exact matching on age and sex.
Automating excellence: A breakthrough in emergency general surgery quality benchmarking.
J Trauma Acute Care Surg
January 2025
From the Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, Department of Surgery (L.A.P., Z.M., J.M., B.H., T.W.C., L.N.H., A.B., L.A., J.J.D., J.E.S.), UC San Diego School of Medicine, San Diego, California; and Division of Acute Care Surgery, Department of Surgery (A.E.L.), University of Missouri School of Medicine, Columbia, Missouri.
Background: Given the high mortality and morbidity of emergency general surgery (EGS), designing and implementing effective quality assessment tools is imperative. Currently accepted EGS risk scores are limited by the need for manual extraction, which is time-intensive and costly. We developed an automated institutional electronic health record (EHR)-linked EGS registry that calculates a modified Emergency Surgery Score (mESS) and a modified Predictive OpTimal Trees in Emergency Surgery Risk (POTTER) score and demonstrated their use in benchmarking outcomes.
View Article and Find Full Text PDFThe abdomen does not lie, but the labs might: Predictors of intra-abdominal injury on computed tomography imaging in pediatric blunt trauma patients.
J Trauma Acute Care Surg
January 2025
From the Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona.
Introduction: Multiple studies have indicated that isolated abnormal laboratory results necessitate obtaining abdominal computed tomography (CT) for pediatric patients with blunt abdominal trauma (BAT), regardless of the normal abdominal examination. This study aims to identify the predictors of intra-abdominal injury (IAI) and the role of laboratory tests in CT imaging among pediatric BAT patients.
Methods: This is a retrospective review at a Level II pediatric trauma center (2018-2022).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!