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 Infection
 Hypovolemia
 Gastric ulcer
 Acute renal failure
In patients with major burn injuries, infection
remains the major cause of death.
 specific deficits in neutrophil chemotaxis,
phagocytosis, and intracellular bacterial killing.
 decreased lymphocyte activation
 reduction in immunoglobulin synthesis
The epidermis of the skin
becomes damaged

allowing microbial the coagulated skin

invasion and exudate

an ideal
environment for
microbial growth
from the liberation of
Burn injury injured vasoactive
area materials

promotes fluid
and protein increases the
Hypovolemi loss into the capillary
a extravascular permeability

Fluid loss from

evaporation on
Gastric Ulcer
 Protection of the gastric and duodenal mucosa:
1. A gel-like mucus film
2. The epithelium secretes HCO3–
3. the epithelium itself
4. Finally, good mucosal blood flow
release of
In patients with serious catecholamines,
burns vasopressin, and

peripheral and
compromise in- splanchnic
organ perfusion vasoconstriction

Bad Mucosal
blood flow
“Erosion of the stomach lining and duodenum
has been demonstrated in 86% of major burn
patients within 72 h of injury, with more than
40% of patients having gastrointestinal

Czaja A, McAlhany JC, Pruitt BA. Acute gastroduodenal disease after thermal
injury: an endoscopic evalution of incidence and natural history. N Engl J
Med 29: 925-29
Acute Renal failure
Diminished blood
burn injury volume and
cardiac output

Elevated levels
catecholamines, decrease in renal
angiotensin, blood
aldosterone and flow and glomerular
vasopressin filtration rate

acute renal
failure damage nefron