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Master Thesis

Méthémoglobinémie chez les brûlés graves : impact du Nitrate de cérium associé à de la Sulfadiazine argentique

Abstract : Introduction: For patients with a body surface area burned more than 30%, a local treatment named Flammacerium is commonly used for its antiseptic and healing properties. Nevertheless, it is the cause of methemoglobinemia from cyanosis to cardiac arrest. Some medical teams prefer not to use this treatment to avoid this complication which is described in the literature. Patients and Methods: A retrospective, single-center study of a cohort of 721 patients between January 2003 and January 2013 in Burn Treatment Center of HIA Percy was used to assess the relationship between exposure to Flammacerium and methemoglobinemia. In this study was included each patient admitted to the acute phase of the burn and having had arterial blood gases. Results: 26 patients had a methemoglobinemia over 3% (3.6%) and 3 patients a methemoglobinemia over 10% (0.4%). When methemoglobinemia reached toxic levels, no symptoms were at the origin of a specific treatment. After multivariate analysis, the burned skin surface, inhalation of fire smoke and exposure to Flammacerium were significantly associated with an increase in methemoglobinemia (p<0,05). Conclusion: As a conclusion, local treatment with Flammacerium is significantly associated with elevated methemoglobinemia. Nevertheless, all methemoglobinemia were subclinical. Faced with the risk / benefit ratio in severe burns, this treatment can thus be used, subject to a daily intake of antioxidant like vitamin C.
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Master Thesis
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Submitted on : Thursday, November 19, 2015 - 2:51:20 PM
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Solène Paul-Girot. Méthémoglobinémie chez les brûlés graves : impact du Nitrate de cérium associé à de la Sulfadiazine argentique. Médecine humaine et pathologie. 2015. ⟨dumas-01231050⟩



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