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PATHOPHYSIOLOGY OF BURN INJURY

Major Burns Loss of skin


barrier
Cell lysis > 30% BSA
Possible
inhalation
Hemolysis Hyperkalemia injury Thermo-
↑ Capillary regulation
Inflammatory
permeability response
problems
Hemoglobin/
myoglobin in Sodium, Water
urine & Protein shift Impaired
↑Concentration immune
from IVS to ITS
of blood cells response
Hyponatremia
↓ Circulating
blood volume Hypoxemia
↑ Blood (up to 50%)
viscosity
Shock (hypovol)

↑ Myocardial Massive stress response, sympathetic ↓ Blood


depressant factor nervous system activation
pressure

Adrenal corticoid hormones &


catecholamine release

Hyperglycemia;↑Catabolism; Risk for


Peripheral
vasoconstriction Tachycardia Curlin’s ulcer; ↑ Metabolism (after burn
shock resolves)
Afterload

Dec.
Cardiac
output

Dec. Tissue
perfusion

Dec. Renal Dec. GI Anaerobic Tissue Cellular


blood flow blood flow metabolism damage dysfunction

Risk of acute Risk of Metabolic Potential tissue Cell


renal failure ileus acidosis necrosis swelling