{
    "abstract": "Blast injuries are complex types of physical trauma resulting from direct or indirect exposure to an explosion, which can be divided into four classes: primary, secondary, tertiary, and quaternary. Primary blast injury results in damage, principally, in gas-containing organs such as the lungs (blast lung injury, BLI). BLI is defined as radiological and clinical evidence of acute lung injury occurring within 12h of exposure to an explosion and not due to secondary or tertiary injury. BLI often combines with cutaneous thermal injury, a type of quaternary blast injury, either in terrorist bomb attacks or in civilian accidental explosions. This report summarizes our experience in the management of combined massive burn and BLI at a Shanghai Burn Center in China.\nA retrospective observational analysis of clinical data was performed for massive burn patients with or without BLI during a 20-year interval. Patient characteristics, causes of injury, clinical parameters, management, and outcomes were recorded and evaluated.\nA total of 151 patients (120 males and 31 females) with severe burn injury (\u226550% TBSA) treated at the Burn Center of Changhai Hospital in Shanghai between July 1997 and June 2017 were enrolled in this study. Their mean age was 38.6\u00b117.8 (3-75) years. Among them, 28 patients had combined BLI and burn injury and 39 patients had no BLI or smoke inhalation injury (non-BLI-SII). No significant difference was observed in the burn area or full-thickness burn area between the two groups. The lowest PaO\nIt is a formidable challenge for clinicians to diagnose and manage massive burn patients combined with BLI. A comprehensive treatment approach is strongly recommended, including fluid resuscitation, airway management, mechanical ventilation, and surgical treatment. Given the high mortality of massive burn patients combined with BLI even in a recognized burn center, more prospective studies are encouraged to assess more effective strategies for the treatment of such patients.",
    "authors": [
        {
            "affiliation": "Burn Center, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.",
            "firstname": "Xing-Feng",
            "initials": "XF",
            "lastname": "Zheng"
        },
        {
            "affiliation": "Burn Center, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.",
            "firstname": "Feng",
            "initials": "F",
            "lastname": "Zhu"
        },
        {
            "affiliation": "Burn Center, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.",
            "firstname": "He",
            "initials": "H",
            "lastname": "Fang"
        },
        {
            "affiliation": "Burn Center, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.",
            "firstname": "Da-Yuan",
            "initials": "DY",
            "lastname": "Xu"
        },
        {
            "affiliation": "Burn Center, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.",
            "firstname": "Long",
            "initials": "L",
            "lastname": "Xu"
        },
        {
            "affiliation": "Burn Center, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.",
            "firstname": "Tian-Sheng",
            "initials": "TS",
            "lastname": "Chen"
        },
        {
            "affiliation": "Burn Center, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.",
            "firstname": "Yong-Jun",
            "initials": "YJ",
            "lastname": "Zheng"
        },
        {
            "affiliation": "Burn Center, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China. Electronic address: huangzhuoxiao4@hotmail.com.",
            "firstname": "Shi-Chu",
            "initials": "SC",
            "lastname": "Xiao"
        },
        {
            "affiliation": "Burn Center, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China. Electronic address: xiazhaofan_smmu@163.com.",
            "firstname": "Zhao-Fan",
            "initials": "ZF",
            "lastname": "Xia"
        }
    ],
    "conclusions": "It is a formidable challenge for clinicians to diagnose and manage massive burn patients combined with BLI. A comprehensive treatment approach is strongly recommended, including fluid resuscitation, airway management, mechanical ventilation, and surgical treatment. Given the high mortality of massive burn patients combined with BLI even in a recognized burn center, more prospective studies are encouraged to assess more effective strategies for the treatment of such patients.",
    "copyrights": "Copyright \u00a9 2018 Elsevier Ltd and ISBI. All rights reserved.",
    "doi": "10.1016/j.burns.2018.11.010",
    "journal": "Burns : journal of the International Society for Burn Injuries",
    "keywords": [
        "Blast lung injury",
        "Burn",
        "Combined injury",
        "Management"
    ],
    "methods": null,
    "publication_date": "2019-12-20",
    "pubmed_id": "31852619",
    "results": "A total of 151 patients (120 males and 31 females) with severe burn injury (\u226550% TBSA) treated at the Burn Center of Changhai Hospital in Shanghai between July 1997 and June 2017 were enrolled in this study. Their mean age was 38.6\u00b117.8 (3-75) years. Among them, 28 patients had combined BLI and burn injury and 39 patients had no BLI or smoke inhalation injury (non-BLI-SII). No significant difference was observed in the burn area or full-thickness burn area between the two groups. The lowest PaO",
    "title": "Management of combined massive burn and blast injury: A 20-year experience.",
    "xml": "<Element 'PubmedArticle' at 0x78850427e610>"
}