ABSTRACT
The paediatric patient we are describing suffered a scald injury covering 83 per cent of the total body surface area (TBSA). This injury was complicated by Klebsiella pneumoniae septicaemia resulting in multiorgan failure (MOF). Acute respiratory distress syndrome (ARDS), gastrointestinal insufficiency, hepathopathy and wound conversion to full thickness posed the main problems. The boy was ventilated with pressure-controlled mechanical ventilation. The concept of permissive hypercapnia (PHC) resulted in a complete resolution of ARDS within 4 weeks. From our experience, further lung injury among infants and children suffering from severe ARDS can be avoided by using controlled mechanical hypoventilation. It is a simple and safe technique that allows adequate oxygenation.
Subject(s)
Bacteremia/therapy , Burns/complications , Klebsiella Infections/therapy , Multiple Organ Failure/therapy , Respiration, Artificial/methods , Respiratory Distress Syndrome, Newborn/therapy , Accidents, Home , Bacteremia/complications , Burns/therapy , Disease-Free Survival , Humans , Hypoventilation , Infant , Infant, Newborn , Klebsiella Infections/complications , Male , Multiple Organ Failure/etiology , Respiratory Distress Syndrome, Newborn/complications , Respiratory Function TestsABSTRACT
A 26-month-old boy sustained a scald injury covering 83 per cent of his total body surface area (TBSA). He also developed sepsis and multiorgan failure (MOF). Locally he was treated with Procel burn cover and silver sulphadiazine cream (SSD) for 23 days. By using Procel, the dressing-change time was shortened significantly. Procel burn cover controlled core and skin temperature more effectively compared to conventional dressing, and the staff acceptance increased because of its easy and fast use. Based on our observation, this material can be used successfully as a total body dressing with children with extensive partial thickness burns or temporarily in full thickness burns until wound excision can be performed.
