Legrand M, Barraud D, Constant I, Devauchelle P, Donat N, Fontaine M, Goffinet L, Hoffmann C, Jeanne M, Jonqueres J, Leclerc T, Lefort H, Louvet N, Losser MR, Lucas C, Pantet O, Roquilly A, Rousseau AF, Soussi S, Wiramus S, Gayat E, Blet A, et al.
Anaesthesia, critical care & pain medicine. Date of publication 2020 Apr 1;volume 39(2):253-267.
1. Anaesth Crit Care Pain Med. 2020 Apr;39(2):253-267. doi:
10.1016/j.accpm.2020.03.006. Epub 2020 Mar 5.
Management of severe thermal burns in the acute phase in adults and children.
Legrand M(1), Barraud D(2), Constant I(3), Devauchelle P(4), Donat N(5), Fontaine
M(6), Goffinet L(7), Hoffmann C(5), Jeanne M(8), Jonqueres J(6), Leclerc T(5),
Lefort H(9), Louvet N(3), Losser MR(10), Lucas C(11), Pantet O(12), Roquilly
A(13), Rousseau AF(14), Soussi S(15), Wiramus S(16), Gayat E(17), Blet A(18).
Author information:
(1)Department of Anaesthesia and Perioperative Care, University of California,
San Francisco, United States. Electronic address: matthieu.m.legrand@gmail.com.
(2)Hôpital de Mercy, Intensive Care Medicine and Burn Centre, CHR
Metz-Thionville, Ars-Laquenexy, France.
(3)Anaesthesiology Department, Hôpital Armand-Trousseau, Sorbonne Université,
Assistance publique-Hôpitaux de Paris, Paris, France.
(4)CHU Lille, Anaesthesia and Critical Care, Burn Centre, 59000 Lille, France.
(5)Burn Centre, Percy Military Teaching Hospital, Clamart, France.
(6)Burn Intensive Care Unit, Saint-Joseph Saint-Luc Hospital, 20, quai
Claude-Bernard, 69007 Lyon, France.
(7)Paediatric Burn Centre, University Hospital of Nancy, 54511
Vandœuvre-Lès-Nancy, France.
(8)CHU Lille, Anaesthesia and Critical Care, Burn Centre, 59000 Lille, France;
University of Lille, Inserm, CHU Lille, CIC 1403, 59000 Lille, France; University
of Lille, EA 7365 - GRITA, 59000 Lille, France.
(9)Department of emergency medicine, Legouest Military Teaching Hospital, Metz,
France.
(10)Hôpital de Mercy, Intensive Care Medicine and Burn Centre, CHR
Metz-Thionville, Ars-Laquenexy, France; Paediatric Burn Centre, University
Hospital of Nancy, 54511 Vandœuvre-Lès-Nancy, France; Inserm UMR 1116, Team 2,
54000 Nancy, France; University of Lorraine, 54000 Nancy, France.
(11)Department of Anaesthesiology, Critical Care and Burn Centre,
Lariboisière-Saint-Louis Hospitals, DMU Parabol, AP-HP Nord, University of Paris,
Paris, France.
(12)Service of Adult Intensive Care Medicine and Burns, Lausanne University
Hospital (CHUV), BH 08-651, Rue du Bugnon 46, 1011 Lausanne, Switzerland.
(13)Department of Anaesthesia and Critical Care, Hôtel-Dieu, University Hospital
of Nantes, Nantes, France; Laboratoire UPRES EA 3826 "Thérapeutiques cliniques et
expérimentales des infections", University of Nantes, Nantes, France.
(14)Burn Centre and Intensive Care Department, University Hospital of Liège,
Liège, Belgium.
(15)Department of Anaesthesiology, Critical Care and Burn Centre,
Lariboisière-Saint-Louis Hospitals, DMU Parabol, AP-HP Nord, University of Paris,
Paris, France; Interdepartmental Division of Critical Care, Keenan Research
Centre for Biomedical Science and Institute of Medical Sciences, Faculty of
Medicine, University of Toronto, Toronto, ON, Canada.
(16)Department of Anaesthesia and Intensive Care Medicine and Burn Centre,
University Hospital of Marseille, La Timone Hospital, Marseille, France.
(17)Department of Anaesthesiology, Critical Care and Burn Centre,
Lariboisière-Saint-Louis Hospitals, DMU Parabol, AP-HP Nord, University of Paris,
Paris, France; Inserm UMR-S 942, Cardiovascular Markers in Stress Conditions
(MASCOT), University of Paris, Paris, France.
(18)Department of Anaesthesiology, Critical Care and Burn Centre,
Lariboisière-Saint-Louis Hospitals, DMU Parabol, AP-HP Nord, University of Paris,
Paris, France; Inserm UMR-S 942, Cardiovascular Markers in Stress Conditions
(MASCOT), University of Paris, Paris, France; Department of Research, University
of Ottawa Heart Institute, Ottawa, ON, Canada.
OBJECTIVES: To provide recommendations to facilitate the management of severe
thermal burns during the acute phase in adults and children.
DESIGN: A committee of 20 experts was asked to produce recommendations in six
fields of burn management, namely, (1) assessment, admission to specialised burns
centres, and telemedicine; (2) haemodynamic management; (3) airway management and
smoke inhalation; (4) anaesthesia and analgesia; (5) burn wound treatments; and
(6) other treatments. At the start of the recommendation-formulation process, a
formal conflict-of-interest policy was developed and enforced throughout the
process. The entire process was conducted independently of any industry funding.
The experts drew up a list of questions that were formulated according to the
PICO model (Population, Intervention, Comparison, and Outcomes). Two bibliography
experts per field analysed the literature published from January 2000 onwards
using predefined keywords according to PRISMA recommendations. The quality of
data from the selected literature was assessed using GRADE® methodology. Due to
the current paucity of sufficiently powered studies regarding hard outcomes (i.e.
mortality), the recommendations are based on expert opinion.
RESULTS: The SFAR guidelines panel generated 24 statements regarding the
management of acute burn injuries in adults and children. After two scoring
rounds and one amendment, strong agreement was reached for all recommendations.
CONCLUSION: Substantial agreement was reached among a large cohort of experts
regarding numerous strong recommendations to optimise the management of acute
burn injuries in adults and children.
Copyright © 2020 The Author(s). Published by Elsevier Masson SAS.. All rights
reserved.
DOI: 10.1016/j.accpm.2020.03.006
PMID: 32147581
