Burn survivors appear to have a reduced capacity for neuroplasticity—the capacity of the brain to change or adapt with experience—early during recovery that normalizes later during recovery, according to a study published in Burns. Researchers compared repetitive transcranial magnet stimulation (rTMS)-induced neuroplasticity in the primary motor cortex of survivors of burn injury with that of controls without burn injury, and they assessed if neuroplasticity is associated with functional recovery in burn survivors. At 6 and 12 weeks after injury, rTMS was applied as spaced continuous theta-burst stimulation (cTBS) to induce neuroplasticity in survivors of burn injury. It was also applied in two sessions separated by 6 weeks in controls. Motor evoked potentials (MEPs) elicited by single-pulse TMS were measured before and after rTMS to measure neuroplasticity. At both experimental sessions, controls showed decreased MEP amplitude 15-30 minutes after spaced cTBS. At 6 weeks after burn injury, survivors showed a smaller change in MEP amplitude after spaced cTBS, but they showed no difference to controls at 12 weeks post-injury. Among survivors of burn injury, a significant positive association was observed between general health outcome and change in MEP amplitude after spaced cTBS at 12 weeks post-injury, suggesting that “burn survivors with normalized neuroplasticity 12 weeks after injury recover faster after burn injury,” according to the study authors.
Model Predicts Inhalation Injury in Patients With Burns
A model that was developed to predict inhalation injury in patients with burn injuries was found to have excellent discrimination, according to a study published in Emergency Medicine Australasia. With no clear method for identifying patients at risk of inhalation injury or requiring intubation in the pre-hospital setting, investigators
sought to identify pre-burn center factors associated with inhalation injury confirmed on bronchoscopy and to develop a prognostic model for inhalation injury. They defined inhalation injury as an Abbreviated Injury Scale of greater than 1 on bronchoscopy and developed a multivariable logistic regression prediction model based on pre-burn center factors. Their model—based on percent total body surface area burned, flame, enclosed space, face burns, hoarse voice, soot in mouth, and shortness of breath being predictive of inhalation injury—provided excellent discrimination, with an area under the curve of 0.87 (95% confidence interval, 0.84-0.91). At non-burn centers, 33% of patients with inhalation injury were intubated, compared with 54% by emergency medical services and 58% at burn centers.
