pathophysiology of burn

this file has all the major pathophysiologies of burn in schematic form.... Enjoy!!!!

1. Cardiovascular alterations
Heat causes coagulation necrosis of skin and subcutaneous tissues

Release of vasoactive peptides

Altered capillary permeability


Loss of fluid severe hypovolemia

Decreased cardiac output decreased myocardial function

Decreased renal blood flow oliguria (renal failure)

Altered pulmonary resistance causing pulmonary oedema

Infection

Systematic inflammatory response syndrome (SIRD)

Multi organ dysfunction syndrome (MODS)

2. Fluid and electrolyte alterations
Burn injury

Release of vasoactive substances (histamine, cytokines, oxidase,
catecholamine etc.)

Increase Vascular permeability

Oedema formation hemoconcentration
(Increased haematocrit)


May cause increase decrease intravascular volume, increase blood tissue
pressure electrolyte & pH imbalance viscosity

Decrease blood flow to skin, initially body compensates with
Kidneys, and gastrointestinal tract increase peripheral vascular
Resistance




Cardiac output decreases

Decrease oxygen of tissues and vital organs

SIRD/MODS

3. Pulmonary alterations
Inhalation of direct heat, hot smoke, carbon mono oxide gases


Direct burn injury to smoke inhalation CO directly
Upper airway binds with haemoglobin and
Form carboxyhemoglobin


Release inflammatory mediators decrease oxygen
Carrying capacity of RBC


Severe upper airway oedema, tissue hypoxia
Bronchospasm


Decreased ventilation decreased oxygenation,
Respiratory acidosis



Severe hypoxia/suffocation

Shock

4. Renal alterations
Burn injury

Release of vasoactive substances and inflammatory mediators

Increase vascular permeability

Fluid shifts from intracellular space to interstitial spaces

Decrease intravascular volume, electrolyte and pH imbalances

Decrease blood volume and cardiac output

Decrease blood supply to renal system

Renal tissue destruction

Renal failure

5. Immunologic alterations
Burn injury


Destruction of the abnormal release of
skin barrier inflammatory factors



Favourable space for impaired neutrophil function and
Microorganism growth and reduction in
and portal for tissue entry lymphocytes
of microbes


Infection of tissues alteration of immune mechanism


Microbes growth and enters into blood


Septicaemia

6. Thermoregulatory alterations
Burn injury


Loss of skin surface, exposure to external environment



Inability to regulate fluid leaks from the
Body temperature burn wound



Increase evaporation from the tissues


Evaporation causes heat loss from the
body


Hypothermia

7. Gastrointestinal alterations
Burn injury

Increase vascular permeability cause oedema

Decrease intravascular volume, electrolyte and pH imbalance

Decrease blood supply to gastrointestinal tract


Mucosal atrophy increased intestinal permeability


Decreased peristaltic movements, overgrowth of GI bacteria
Decreased absorption which translocate to
Other organs



Paralytic ileus, gastric distention septicaemia


Curling ulcers

Gastric bleeding

8. Metabolic alterations
Burn injury

Stress


Catecholamine cortisol


Glucagon


Gluconeogenesis peripheral lipolysis proteolysis


Increase glucose increase free fatty acids increased
Amino acids


Hyper metabolism


Metabolic acidosis