The Effects of Pre-Burn Center Intubation on Rates of Pneumonia, Early Extubation, and Death: A Systematic Review.

Journal of Trauma Nursing : the Official Journal of the Society of Trauma Nurses
Jason Donnelly

Abstract

Airway burns cause delayed collapse of airways due to airway edema. Transferring clinicians are trained to intubate at the first suspicion of airway collapse, which can lead to vague reasons for intubation such as "airway protection." Intubation, however, is not without risks, such as pneumonia and death. The objective of this research review is to compare pre-burn center intubations with those performed at burn centers and compare rates of pneumonia, mortality, and time to extubation. A systematic review of articles from MEDLINE and CINAHL Plus was performed to identify eligible trials and observational studies that compared pre-burn center intubations with those performed at burn centers between the years 2014 and 2018. Four studies met eligibility requirements. There were mixed results on the correlation of pre-burn center intubation with pneumonia and death; however, pre-burn center patients were more likely to have earlier extubation times, which points to potentially unnecessary intubations. Clinicians should be aware of the increased mortality and morbidity associated with intubation. Providers should use objective evidence-based tools such as the ABA (American Burn Association) and Denver criteria to determine the need ...Continue Reading

References

Jul 31, 2013·Burns : Journal of the International Society for Burn Injuries·Wang ChengZhang Guo-an
Aug 19, 2015·Journal of Burn Care & Research : Official Publication of the American Burn Association·Kathleen S RomanowskiDavid G Greenhalgh
Oct 25, 2016·Journal of Burn Care & Research : Official Publication of the American Burn Association·Anthony R CaiSteven E Wolf
Nov 11, 2017·Burns : Journal of the International Society for Burn Injuries·Daniel FrenoSteven A Kahn
Feb 21, 2018·Annals of Plastic Surgery·Guillermo FoncerradaJong O Lee
Mar 20, 2018·Burns : Journal of the International Society for Burn Injuries·Jenelle H BadulakErik Peltz

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