A case of successful intensive treatment of a child with a severe burn injury

V.A. Matskevich1, Yu.B. Shukhat1, J.N. Kolegova1, O.L. Maximova1, E.O. Vasilieva1,2, A.I. Gritsan1,2

1 Krasnoyarsk Regional Clinical Hospital, Regional Public Health Institution, Krasnoyarsk

2 Krasnoyarsk State Medical University named after professor V.F. Voyno-Yasenetsky, Ministry of Health of the Russian Federation, Krasnoyarsk

For correspondence: Alexey I. Gritsan, Dr. med. Sci., Professor, Chief of the Department of Anaesthesiology and Intensive Care Krasnoyarsk of the State Medical University named after Professor V.F. Voyno-Yasenetsky, Ministry of Health of the Russian Federation, Krasnoyarsk; e-mail: gritsan67@mail.ru

For citation: Matskevich VA, Shukhat YuB, Kolegova JN, Maximova OL, Vasilieva EO, Gritsan AI. A case of successful intensive treatment of a child with a severe burn injury. Alexander Saltanov Intensive Care Herald. 2019;1:100–3.

DOI: 10.21320/1818-474X-2019-1-100-103


In this article presented the positive clinical experience of treatment of a child with deep extensive burns up to 85 % of the body surface. It is proved that successful treatment of this patient is possible only in a multidisciplinary clinic with combination of active surgical tactics, balanced infusion-transfusion, adequate antibacterial and immuno-substitutive therapy, control of microbiome of wound secret and biological fluids, usage of the air fluidized bed, personified dressing tactics, suitable nutritional support, a complex of modern rehabilitation measures.

Keywords: child, burn, narcosis, necrectomy, autodermoplasty, intensive care, wounds, air fluidized bed, antibiotics, rehabilitation

Received: 23.11.2018

Accepted: 01.03.2019


  1. Карваял Х.Ф., Паркс Д.Х. Ожоги у детей. M:. Медицина, 1990.
  2. [Carwayal H.F., Parks D.H. Burns in children. M:. Medicine, 1990. (In Russ)]
  3. Парамонов Б.А., Порембский Я.О., Яблонский В.Г. Ожоги: руководство для врачей. СПб: СпецЛит, 2000.
  4. [Paramonov B.A., Porembsky Ya.O., Yablonsky V.G. Burns: A Guide for Doctors. St. Petersburg: SpecLit, 2000. (In Russ)]
  5. Шень Н.П. Ожоги у детей. М.: Триада-Х, 2011.
  6. [Shen N.P. Burns in children. M.: Triada-X, 2011. (In Russ)]
  7. Назаров И.П., Мацкевич В.А., Колегова Ж.Н. и др. Ожоги: интенсивная терапия. Учебное пособие. Ростов-на-Дону: Феникс, 2007.
  8. [Nazarov I.P., Matskevich V.A., Kolegova J.N., et al. Burns: Intensive care. Tutorial. Rostov-on-Don: Phoenix, 2007. (In Russ)]
  9. Мустафаев А.М., Панахова Э.С. Ожоговый шок у детей. Баку, 1990.
  10. [Mustafaev A.M., Panakhova E.S. Burn shock in children. Baku, 1990. (In Russ)]
  11. Кавалевский Г.М., Петров Н.В., Силин Л.Л. Комбинированная термомеханическая травма. М.: Медицина, 2005.
  12. [Kavalevsky G.M., Petrov N.V., Silin L.L. Combined thermomechanical injury. M:. Medicine, 2005. (In Russ)]
  13. Библиотека комбустиолога [электронный ресурс]: http://combustiolog.ru/spetsialistam/biblioteka/
  14. [Combustiology Library: http://combustiolog.ru/spetsialistam/biblioteka/ (In Russ)]
  15. Лекманов А.У., Азовский Д.К., Пилютик С.Ф., Будкевич Л.И. Интенсивная терапия у детей с обширными ожогами первые 24 ч после повреждения — результаты интерактивного опроса. Вестник анестезиологии и реаниматологии. 2018; 15(1): 18–26. DOI.org/10.21292/2078-5658-2018-15-1-18-26
  16. [Lekmanov A.U., Azovskiy D.K., Pilyutik S.F., Budkevich L.I. Intensive therapy in children with extensive burns the first 24 hours after injury — the results of an interactive survey. Bulletin of anesthesiology and resuscitation. 2018; 15(1): 18–26. DOI: 10.21292/2078-5658-2018-15-1-18-26. (In Russ)]
  17. Лекманов А.У., Азовский Д.К., Пилютик С.Ф. Пути снижения инфузионной нагрузки у детей с обширными ожогами в первые 24 ч после повреждения. Вестник анестезиологии и реаниматологии. 2016; 13(4): 30–35.
  18. [Lekmanov A.U., Azovskiy D.K., Pilyutik S.F. Ways to reduce infusion load in children with extensive burns in the first 24 hours after injury. Bulletin of anesthesiology and resuscitation. 2016; 13(4): 30–35. (In Russ)]
  19. Сепсис: классификация, клинико-диагностическая концепция и лечение. Под ред. Б.Р. Гельфанда. М.: Медицинское информационное агентство, 2017.
  20. [Sepsis: classification, clinical diagnostic concept and treatment / Ed. B.R. Gelfand. Moskow: Medical News Agency, 2017. (In Russ)]
  21. Стратегия и тактика применения антимикробных средств в лечебных учреждениях России. Российские национальные рекомендации. Под ред. В.С. Савельева, Б.Р. Гельфанда, С.В. Яковлева. М, 2012. [Strategy and tactics of the use of antimicrobial agents in medical institutions in Russia. Russian national recommendations / ed. V.S. Saveliev, B.R. Gelfund, S.V. Yakovlev. Moscow, 2012. (In Russ)]
  22. Руководство по клиническому питанию: практическое руководство. Под. ред. В.М. Луфта, С.Ф. Багненко. 2-е изд, доп. СПб: Арт-Экспресс, 2013.
  23. [Guide to clinical nutrition: a practical guide / Under. ed. V.M.Lufta, S.F.Bagnenko, second edition, enlarged. St. Petersburg: Art-Express, 2013. (In Russ)]

Clinical Parallels of the Tactics of Volemic Resuscitation and Nutritional Support with the Outcomes of Severe Thermal Burns in Children

K.S. Botvina, N.P. Pyshmintseva, N.P. Shen, Yu.Kh. Sayfitdinov, D.V. Suchkov

Department of anesthesiology and resuscitation of the Institute of continuous professional development Tyumen state medical university Ministry of Healthcare Russian Federation; Provincial clinical hospital № 1, Tyumen

For correspondence: Natalia Petrovna Shen — M.D., professor, chairman of department of anesthesiology and resuscitation of the institute of continuous professional development Tyumen GMU of the Ministry of Pub. Health of Russia, Tyumen; e-mail: nataliashen@rambler.ru

For citation: Botvina KS, Pyshmintseva NP, Shen NP, Sayfitdinov YuKh, Suchkov DV. Clinical Parallels of the Tactics of Volemic Resuscitation and Nutritional Support with the Outcomes of Severe Thermal Burns in Children. Intensive Care Herald. 2017;2:17–20.

In the article are studied the demographic, tactical and prognostic aspects of burn disease in children for the purpose of the devel- opment of the important clinical parallels, including of the mechanisms, which start the multiple organ system dysfunction, infectious complications and death. The results of a study showed that prevalence and the depth of defeat does not be determining for the possi- bility to master nourishment and it must not become the factor, which impedes the beginning of nutritional support within maximally early periods. The authors also established that the positive fluid balance administered for the first three days of ICU in children with the severe burns is not the predictor of complications or lethal outcome, which separates this population of patients from the number of majority of the patients, in whom the so-called Fluid overload is the independent factor of the risk of complications and lethal outcome.

Keywords: burn, children, severe thermal burns

Received: 08.03.2017


  1. Finkelstein A., Corso P.S., Miller T.R. Incidence and Economic Burden of Injuries in the United States. J. Epidemiol. Community Health. 2007; 61(10): 926. doi: 10.1136/jech.2007.059717.
  2. Thombs D., Singh V.A., Halonen J. et al. The effects of preexisting medical comorbidities on mortality and length of hospital stay in acute burn injury: evidence from a national sample of 31,338 adult patients. Ann. Surg. 2007; 245(4): 629–634. doi: 10.1097/01.sla.0000250422.36168.67.
  3. Klein B., Goverman J., Hayden D.L. et al. Benchmarking Outcomes in the Critically Injured Burn Patient. Ann. Surg. 2014; 259(5): 833–841. doi: 10.1097/SLA.0000000000000438.
  4. Kayilioglu S.I., Dinc , Sozen I. et al. Postoperative fluid management. World J. Crit. Care Med. 2015; 4(3): 192–201. doi: 10.5492/wjccm.v4.i3.192.
  5. Gunst , Derese I., Aertgeerts A. et al. Insufficient autophagy contributes to mitochondrial dysfunction, organ failure, and adverse outcome in an animal model of critical illness. Crit. Care Med. 2013; 41(1): 182–194. doi: 10.1097/CCM.0b013e3182676657.
  6. Глушкова Е.Г., Глушков В.С., Калинин Е.П. и др. Изменение проницаемости мембран эритроцитов для АТФ при их сдвиговой деформации в условиях активации свободно-радикального окисления. Медицинская наука и образование Урала, 2016; 3; 40–44. [Glushkova Ye.G., Glushkov V.S., Kalinin Ye.P. et al. Izmenenie pronitsaemosti membran eritrotsitov dlya ATF pri ih sdvigovoi deformatsii v usloviyah aktivatsii svobodno-radikal’nogo okisleniya. Meditsinskaya nauka i obrazovanie Urala. 2016; 3; 40–44. (In Russ)]
  7. Kraft R., Herndon D.N., Al-Mousawi A.M. et al. Burn size and survival probability in paediatric patients in modern burn care: a prospective observational cohort study. Lancet. 2012; 379(9820): 1013–1021. doi: 1016/S0140-6736(11)61345-7.
  8. Lari A.R., Panjeshahin M.R., Talei R. et al. Epidemiology of childhood burn injuries in Fars province, Iran. J. Burn Care Rehabil. 2002; 23(1): 39–45.
  9. Шень Н.П., Поляков А.П., Сайфитдинов Ю.Х. Положение об оказании неотложной помощи пострадавшим с термической травмой в Тюменской области. Инструктивно-методич. указания. Тюмень: Академия, 2007. [Shen P., Polyakov A.P., Sayfitdinov Yu.Kh. Polozhenie ob okazanii neotlozhnoi pomoshchi postradavshim s termicheskoi travmoi v Tumenskoi oblasti. Instructivno-metodicheskie ukazaniya. Tyumen: Akademiya, 2007. (In Russ)]
  10. Shankar-Hari , Phillips G.S., Levy M. et al. Developing a New Definition and Assessing New Clinical Criteria for Septic Shock For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315(8): 775–787. doi: 10.1001/jama.2016.0289.
  11. Bernard R., Artigas A., Brigham KL, et al. Report of the American-European consensus conference on ARDS: definitions, mechanisms, relevant outcomes and clinical trial coordination. The Consensus Committee. J. Crit. Care. 1994; 9(1): 72–81.
  12. Лекманов А.У., Будкевич Л.И., Сошкина В.В. Оптимизация антибактериальной терапии у детей с обширной ожоговой травмой, основанная на уровне прокальцитонина. Вестник интенсивной терапии. 2009; 1; 33–38. [Lekmanov A.U., Budkevich L.I., Soshkina V.V. Optimizatsiya antibakterial’noi terapii u detei s obshirnoi ozhogovoi travmoi, osnovannaya na urovne prokal’tsitonina. Vestnik intensivnoy terapii. 2009; 1; 33–38. (In Russ)]