Anesthetic Considerations for Major Burn Injury In Pediatric Patients

Abstract

The applied principles of modern pediatric burn managementhave achieved an overall decline in morbidity and mortalityaccompanied by improvements in long-term functional outcomesand the assisted reintegration of the patient into theirfamilial and social environments. However, treatment of thepediatric burn patient continues to test the skill set of the anesthesiaprovider and the multidisciplinary team. Initial managementremains focused on targeted resuscitation, caloricreplacement, and the delivery of effective anxiolysis and analgesiaboth in the intensive care unit and during a multitude ofsurgical excisions. There are continuing research efforts evaluatingthe pharmacologic mediation of the catabolic state andprotracted inflammatory response. Although the acute burnphase requires an intense commitment to identify and addressevolving physiologic derangements, the anesthesiologist is alsochallenged by the sequelae of the original injury as this uniquepatient population revisits the operating room over the courseof several years.