Aerobic exercise is important in the rehabilitation of individuals with prior burn injuries, but no studies have examined whether adult burn survivors demonstrate cardiac remodeling to long-term aerobic exercise training. In this study, we tested the hypothesis that 6 months of progressive exercise training improves cardiac magnetic resonance imaging-based measures of cardiac structure and function in well-healed burn survivors. Secondary analyses explored relations between burn surface area and changes in cardiac structure in the cohort of burn survivors. V̇o assessments and cardiac magnetic resonance imaging were performed at baseline and following 6 months of progressive exercise training from 19 well-healed burn survivors and 10 nonburned control participants. V̇o increased following 6 months of training in both groups (Control: Δ5.5 ± 5.8 mL/kg/min; Burn Survivors: Δ3.2 ± 3.6 mL/kg/min, main effect of training, < 0.001). Left ventricle (LV) mass (Control: Δ1.7 ± 3.1 g/m; Burn survivors: Δ1.8 ± 2.7 g/m), stroke volume (Control: Δ5.8 ± 5.2 mL/m; Burn Survivors: Δ2.8 ± 4.2 mL/m), and ejection fraction (Control: Δ2.4 ± 4.0%; Burn Survivors: Δ2.2 ± 4.3%) similarly increased following 6 months of exercise training in both cohorts (main effect of training < 0.05 for all indexes). LV end-diastolic volume increased in the control group (Δ6.5 ± 4.5 mL/m) but not in the cohort of burn survivors (Δ1.9 ± 2.7 mL/m, interaction, = 0.040). Multiple linear regression analyses revealed that burn surface area had little to no effect on changes in ventricular mass or end-diastolic volumes in response to exercise training. Our findings provide initial evidence of physiological cardiac remodeling, which is not impacted by burn size, in response to exercise training in individuals with well-healed burn injuries. Aerobic exercise is important in the rehabilitation of individuals with prior burn injuries, but no studies have examined whether adult burn survivors demonstrate cardiac remodeling to long-term aerobic exercise training. In this study, we tested the hypothesis that 6 months of progressive exercise training would improve cardiac magnetic resonance imaging-based measures of cardiac structure and function in well-healed burn survivors. Our findings highlight the ability of exercise training to modify cardiac structure and function in well-healed burn survivors and nonburned sedentary controls alike.
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http://dx.doi.org/10.1152/japplphysiol.00630.2022 | DOI Listing |
J Pediatr Surg
December 2024
Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. Electronic address:
Introduction: Indications for extracorporeal membrane oxygenation (ECMO) in pediatric trauma continue to evolve. This study evaluates trends and practices in ECMO use for injured children and identifies factors associated with mortality using the National Trauma Data Bank (NTDB).
Methods: We conducted a retrospective review of children ≤18 years who underwent ECMO therapy following trauma, recorded in the NTDB from 2007 to 2018.
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.
Resuscitation
January 2025
Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Royal Prince Alfred Hospital, Sydney, Australia. Electronic address:
Background: The use of extracorporeal membrane oxygenation (ECMO) during cardiopulmonary resuscitation (ECPR) is increasing. Prehospital ECPR (PH-ECPR) for out-of-hospital cardiac arrest (OHCA) may improve both equity of access and outcomes but its cost effectiveness has yet to be determined.
Methods: Cost analyses of PH-ECPR was performed utilizing current PH-ECPR trial, NSW Ambulance Cardiac Arrest Registry (CAR), geospatial modelling and in-hospital costings data.
Ann Burns Fire Disasters
December 2024
Department of Bioengineering, VIT, Bhopal, India.
Resuscitation of burns remains a fundamental problem in burn care. Traditional endpoints such as mean arterial pressure and urine output guide fluid therapy for optimal resuscitation, but an ideal marker remains controversial. Base deficit and serum lactate are markers of global tissue acidosis and inadequate oxygenation.
View Article and Find Full Text PDFEur Burn J
November 2024
Department of Surgery, University of Washington, Seattle, WA 98195, USA.
In this study, we aimed to integrate a genetic repository with an existing longitudinal national burn database. We set out two primary objectives, namely (1) to develop standard operating procedures for genetic sample collection and storage, DNA isolation, and data integration into an existing multicenter database; and (2) to demonstrate the feasibility of correlating genetic variation to functional outcomes in a pilot study, using the catechol-O-methyltransferase (COMT) gene. Dubbed the worrier/warrior gene, COMT variants have been associated with varying phenotypes of post-traumatic stress, wellbeing, and resilience.
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