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신동욱 ( Dong Wook Shin ),장준흠 ( Junheum Jang ),강화자 ( Wha Ja Kang ) 경희대학교 경희의료원 2014 慶熙醫學 Vol.29 No.1
The burned patient has many problems like dehydration, oliguria and protein defficiency. Because homeostatic controls are markdly impaired, the cardiovascular system may be unable to respond to the changes in body position frequently necessary during surgical procedures. Especially when the burn involves the head, neck, and upper chest, the mucous membrane of the respiratory tract may be edematous and pulmonary atelectasis may be present. And shock, hyperdynamic circulation, decreased serum albumin concentration, increased α1-acid-glycoprotein concentration, and altered receptor sensitivity change the respose to various drugs. The response to depolarizing and nondepolarizing muscle relaxants remains unaltered during 24 hours after burn injury. However, after first day, the response remain altered by the various mechanism. Doctors must always keep in mind that the understandings of pathophysiology and anesthetic management management in burned patient are important.