Flashcards in Chpt 26 PATHOPHYSIOLOGY OF BURN INJURY Deck (16):
What is burns path
Burns are complex injuries with loss of tissue integrity that cause patients to develop many physiologic, metabolic, and psychological changes.
The tissue destruction caused by a burn injury affects
fluid and electrolyte balance, and leads to local and systemic problems, including fluid and protein losses, sepsis, and changes in metabolic, endocrine, respiratory, cardiac, hematologic, and immune functioning.
the epidermis is the only part of the skin that is injured.
involves the entire epidermis and varying depths of the dermis
destruction of the entire epidermis and dermis, leaving no true skin cells to repopulate; therefore, skin will not regrow.
After a burn injury, there is a massive fluid loss through
Blood vessels to the burned skin are occluded, and blood flow is reduced or stopped.
• Damaged macrophages within the tissues release chemical mediators that cause blood vessel constriction.
• Blood vessel thrombosis may occur, causing necrosis
fluid shift occurs after initial vasoconstriction
dilating and leaking fluids into the interstitial space
continuous leak of plasma fluids and proteins from the vascular space into the interstitial space, which
decreases blood volume and blood pressure.
Profound disruptions of fluid and electrolyte balance and acid-base balance
imbalances include hypovolemia, metabolic acidosis, hyperkalemia, and hyponatremia.
Fluid remobilization starts about
24 hours after injury, when the capillary leak stops and capillary integrity is restored.
diuretic stage begins at about
48 to 72 hours after the burn injury as capillary membrane integrity returns.
Heart rate increases and cardiac output decreases because of
the initial fluid shifts and hypovolemia that occur after a burn injury.
Cardiac output may remain low until
18 to 36 hours after the burn injury.
Cardiac output increases with
fluid resuscitation and reaches normal levels before plasma volume is restored completely.