Critical care management in burns: a review of current evidence and guidelines - Part 2

Recent literature on the management of critically ill patients has altered the beliefs and clinical behaviours, questioning many dogmas that were practised without much evidence. The critical care in a severely burn-injured patient requires special attention in resuscitation, haemodynamic monitoring, management of complications, organ support and determinants of outcome. The goal of resuscitation is to maintain intravascular volume and tone while correcting the reversible changes in altered physiology, aided by early debridement of burned tissue and elimination of the source of physiological derangement. Practitioners should target resuscitation based on goal-directed therapy using non-invasive markers of cardiac output. The management requires the input of a multi-disciplinary team to achieve critical care and early surgical intervention and management of complications and organ support.