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Following the introduction in 1988 of a regimen of selective decontamination of the digestive tract (SDD) for extensively injured patients in our burns centre, colonization rates with Gram-negative organisms declined significantly, but colonization with Staphylococcus aureus was unaffected. In an effort to reduce staphylococcal colonization, the SDD regimen(More)
BACKGROUND Pulmonary coagulopathy is intrinsic to pneumonia and other forms of acute lung injury. We hypothesized patients with burn injuries and inhalation trauma to have similar alterations in pulmonary coagulation and fibrinolysis. METHODS We performed a prospective study on changes in pulmonary and systemic thrombin generation and fibrinolytic(More)
Evidence from studies of trauma patients suggests that selective decontamination of the digestive tract (SDD) might also be of value in preventing colonization and infection by enteric organisms in burn patients. In a retrospective study, 31 consecutive patients with burns of greater than 30% of total body surface area, admitted over a 2-year period, who(More)
An analysis of 23 CT scans performed on 20 patients was carried out in an approximate 2-yr period. In 15 patients, CT scans were judged useful by subsequent clinical course when they indicated maintenance or alteration of existing treatment strategies. CT scans in five patients were not helpful. When judged by eventual outcome, the impact of CT scans(More)
BACKGROUND Data relating to patients admitted with extensive burn injuries in the Netherlands have revealed a marked increase in patients whose initial care included mechanical ventilation (MV). The increase was abrupt, dating from 1997, and has been sustained since. The aim of this study is to quantify this observation and to discuss possible causes. (More)
BACKGROUND Burn patients with inhalation injury (INHI) require more fluid resuscitation than patients without INHI. However, the relation between INHI and fluid resuscitation may be confounded by a ventilation-induced increase in fluid retention. We therefore evaluated whether INHI was independently of continuous positive pressure ventilation (CPPV)(More)
INTRODUCTION Soluble urokinase-type plasminogen activator receptor (suPAR) has been proposed as a biologic marker of fibrinolysis and inflammation. The aim of this study was to investigate the diagnostic and prognostic value of systemic and pulmonary levels of suPAR in burn patients with inhalation trauma who need mechanical ventilation. METHODS suPAR was(More)
BACKGROUND Pulmonary coagulopathy is a hallmark of lung injury following inhalation trauma. Locally applied heparin attenuates lung injury in animal models of smoke inhalation. Whether local treatment with heparin benefits patients with inhalation trauma is uncertain. The present trial aims at comparing a strategy using frequent nebulizations of heparin(More)
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