Recent advances in burn care

The patient with severe burn injuries offers significant challenges to the anesthesiologist. Inhalation injury continues to be the most significant contributor to morbidity and mortality despite recent advances in the techniques of mechanical ventilation and respiratory therapy. Operative procedures are complicated by the presence of severe pulmonary injury, massive blood loss, significant fluid shifts, and hypermetabolism, which alter the pharmacokinetics of many anesthetic agents. Recent advances in nutrition, respiratory support, the early excision of burns, and skin substitutes are improving survival from massive burns and decreasing the resultant disability.