Nomogram for predicting the risk of anxiety and depression in patients with non-mild burns

BACKGROUND Post-burn anxiety and depression affect considerably the quality of life and recovery of patients;however,limited research has demonstrated risk factors associated with the development of these conditions.AIM To predict the risk of developing post-burn anxiety and depression in patients with non-mild burns using a nomogram model.METHODS We enrolled 675 patients with burns who were admitted to The Second Affiliated Hospital,Hengyang Medical School,University of South China between January 2019 and January 2023 and met the inclusion criteria.These patients were randomly divided into development(n=450)and validation(n=225)sets in a 2:1 ratio.Univariate and multivariate logistic regression analyses were conducted to identify the risk factors associated with post-burn anxiety and depression dia-gnoses,and a nomogram model was constructed.RESULTS Female sex,age<33 years,unmarried status,burn area≥30%,and burns on the head,face,and neck were independent risk factors for developing post-burn anxiety and depression in patients with non-mild burns.The nomogram model demonstrated predictive accuracies of 0.937 and 0.984 for anxiety and 0.884 and 0.923 for depression in the development and validation sets,respectively,and good predictive per-formance.Calibration and decision curve analyses confirmed the clinical utility of the nomogram.CONCLUSION The nomogram model predicted the risk of post-burn anxiety and depression in patients with non-mild burns,facilitating the early identification of high-risk patients for intervention and treatment.

Community Knowledge and Attitude about Burns First Aid (BFA) in Jazan, Saudi Arabia

Introduction and Significance: Burn injury (BI) is a considerable health issue which is responsible for around 300,000 deaths and affecting about 11 million people every year worldwide. In Saudi Arabia, the prevalence of BIs array from 112 to 518 per 100,000 per year. The appropriate awareness of performing first aid could facilitate to improve the outcomes of burns. Purpose and Objectives: To appraise the community that acknowledges burns, first aid, and associated factors among the community population in Jazan City, Saudi Arabia. The paper aims to identify limitations to encourage additional research and persuade legislators to develop improved burn-injury care recommendations and training programs. Materials and Methods: An observational-based sample survey was conducted among the people who live in Jazan City aging 13 years or more, during April 5 to May 5, 2023. Data collection was done by a validated online self-administrated questionnaire sent randomly to community members in different parts of Jazan City via social media platforms. Collected data were coded and cleaned by an excel program, and finally exported on SPSS 26.0 software. The variables were analyzed using descriptive statistics like frequencies and percentages. Also, the Chi-square test was used to investigate the relation between different variables, with a significance value of P Results: This study included 243 participants (about 62%) among them were mostly male participants (151) having a university degree. The majority of participants 75% did not take any form of BFA training in the past. This study shows that 69.9% of the participants have inadequate awareness, despite 72% having a constructive attitude towards burn first aid. Previous burn-related first aid training was significantly associated with participants’ knowledge of BFA at a p-value less than 0.05. Conclusion: This study indicates a high frequency of Jazan population having inadequate knowledge of burn first aid despite the high prevalence of a favorable attitude. There is a need to develop an effective nationwide burn prevention program and early burn first aid treatment in Saudi Arabia and promote a consistent guideline for burn first aid.

Analysis of the Cicatricial Acceleration Method (MAC®) in Skin Repair in Wistar Rattus norvegicus with Induced Chemical Burns

Introduction: The cicatricial acceleration method (MAC®) promotes photobiological effects of an anti-inflammatory and healing nature. Its therapeutic radiation is emitted, producing photobiostimulant effects that result in rapid tissue repair and better tissue quality. The treatment of burns has always been a challenge, which involves both performing surgery and controlling and guiding scar regeneration, avoiding possible morbidities. Objective: To evaluate the effects of applying the MAC methodology with an AlGa (aluminum, gallium arsenide) laser on the time and quality of tissue repair in the skin of rats after induced chemical burns. Method: 22 adult male rats were subjected to a second-degree chemical burn on the back using 50% trichloroacetic acid. After the burns, the animals were randomly separated into 2 groups: control and experimental. The control group (G1) received placebo laser therapy and the laser group (G2) underwent laser irradiation with an energy density of 100 J/cm2. Histological analysis and macroscopic evaluation were carried out by means of the paper template method. Results: Group G1 showed (53%) of the necrosis area and group G2 showed (11%) necrosis area. Conclusion: The cicatricial acceleration method (MAC®) favored the repair of wounds caused by a 2nd-degree chemical burn, optimizing time and improving quality.

A Rational Design of Metal–Organic Framework Nanozyme with High‑Performance Copper Active Centers for Alleviating Chemical Corneal Burns

Metal–organic frameworks(MOFs)have attracted significant research interest in biomimetic catalysis.However,the modulation of the activity of MOFs by precisely tuning the coordination of metal nodes is still a significant challenge.Inspired by metalloenzymes with well-defined coordination structures,a series of MOFs containing halogen-coordinated copper nodes(Cu-X MOFs,X=Cl,Br,I)are employed to elucidate their structure–activity relationship.Intriguingly,experimental and theoretical results strongly support that precisely tuning the coordination of halogen atoms directly regulates the enzyme-like activities of Cu-X MOFs by influencing the spatial configuration and electronic structure of the Cu active center.The optimal Cu–Cl MOF exhibits excellent superoxide dismutase-like activity with a specific activity one order of magnitude higher than the reported Cu-based nanozymes.More importantly,by performing enzyme-mimicking catalysis,the Cu–Cl MOF nanozyme can significantly scavenge reactive oxygen species and alleviate oxidative stress,thus effectively relieving ocular chemical burns.Mechanistically,the antioxidant and antiapoptotic properties of Cu–Cl MOF are achieved by regulating the NRF2 and JNK or P38 MAPK pathways.Our work provides a novel way to refine MOF nanozymes by directly engineering the coordination microenvironment and,more significantly,demonstrating their potential therapeutic effect in ophthalmic disease.

A 94-year-old patient with severe burns: a case report

Burns often happen unexpectedly and have the potential to cause death,lifelong disfigurement and dysfunction.[1]According to the depth of the burn wound and extent of affected burned body surface area,burns are classifi ed as mild or severe.Mild burns usually refer to burns that encompass less than 10%of the total body surface area(TBSA),mainly superficial burns.Severe burns are defined as TBSA>10%in elderly patients,TBSA>20%in adults,and TBSA>30%in children.[2]Burn injuries,particularly severe burns,are accompanied by an immune and inflammatory response,metabolic changes and distributive shock that can be challenging to manage and can lead to multiple organ failure.[3]Therefore,burn care providers face many challenges,including acute and critical care management,long-term care,and rehabilitation.Here,we report a 94-year-old patient with severe burns who recovered well and was discharged from the hospital in a wheelchair.

基于改良Burns撤机评分量表的程序化撤机方案在机械通气>48h重症病人中的应用

目的:探讨运用改良Burns撤机评分量表启动程序化撤机方案对机械通气>48 h重症病人撤机的应用效果。方法:选取我院重症监护室(ICU)机械通气>48 h的重症病人为研究对象,将2021年1月—2021年6月的61例由医生凭临床经验评估撤机的病人设为对照组;2021年7月—2021年12月的61例按基于改良Burns撤机评分量表的程序化撤机方案进行撤机的病人作为试验组。比较两组每日撤机筛查及时率、第1次自主呼吸试验(SBT)成功率、撤机时间、平均机械通气时间、撤机失败率、ICU住院时间。结果:试验组每日撤机筛查及时率、第1次SBT成功率高于对照组,撤机时间及平均机械通气时间短于对照组,差异有统计学意义(P<0.05)。两组撤机失败率、ICU住院时间比较,差异无统计学意义(P>0.05)。结论:基于改良Burns撤机评分量表的程序化撤机方案缩短了病人平均机械通气时间以及撤机的时间。ICU护士经过培训后有足够的能力主导程序化撤机,撤机过程中病人更易获得护士的全面监护及心理照护,减轻了病人的痛苦,提高了病人的就医体验。

Integration of Multiple Spectral Data via a Logistic Regression Algorithm for Detection of Crop Residue Burned Areas:A Case Study of Songnen Plain,Northeast China

The burning of crop residues in fields is a significant global biomass burning activity which is a key element of the terrestrial carbon cycle,and an important source of atmospheric trace gasses and aerosols.Accurate estimation of cropland burned area is both crucial and challenging,especially for the small and fragmented burned scars in China.Here we developed an automated burned area mapping algorithm that was implemented using Sentinel-2 Multi Spectral Instrument(MSI)data and its effectiveness was tested taking Songnen Plain,Northeast China as a case using satellite image of 2020.We employed a logistic regression method for integrating multiple spectral data into a synthetic indicator,and compared the results with manually interpreted burned area reference maps and the Moderate-Resolution Imaging Spectroradiometer(MODIS)MCD64A1 burned area product.The overall accuracy of the single variable logistic regression was 77.38%to 86.90%and 73.47%to 97.14%for the 52TCQ and 51TYM cases,respectively.In comparison,the accuracy of the burned area map was improved to 87.14%and 98.33%for the 52TCQ and 51TYM cases,respectively by multiple variable logistic regression of Sentind-2 images.The balance of omission error and commission error was also improved.The integration of multiple spectral data combined with a logistic regression method proves to be effective for burned area detection,offering a highly automated process with an automatic threshold determination mechanism.This method exhibits excellent extensibility and flexibility taking the image tile as the operating unit.It is suitable for burned area detection at a regional scale and can also be implemented with other satellite data.

Nonlinear dynamics of the reversed shear Alfvén eigenmode in burning plasmas

In a tokamak fusion reactor operated at steady state,the equilibrium magnetic field is likely to have reversed shear in the core region,as the noninductive bootstrap current profile generally peaks off-axis.The reversed shear Alfvén eigenmode(RSAE)as a unique branch of the shear Alfvén wave in this equilibrium,can exist with a broad spectrum in wavenumber and frequency,and be resonantly driven unstable by energetic particles(EP).After briefly discussing the RSAE linear properties in burning plasma condition,we review several key topics of the nonlinear dynamics for the RSAE through both wave-EP resonance and wave-wave coupling channels,and illustrate their potentially important role in reactor-scale fusion plasmas.By means of simplified hybrid MHD-kinetic simulations,the RSAEs are shown to have typically broad phase space resonance structure with both circulating and trapped EP,as results of weak/vanishing magnetic shear and relatively low frequency.Through the route of wave-EP nonlinearity,the dominant saturation mechanism is mainly due to the transported resonant EP radially decoupling with the localized RSAE mode structure,and the resultant EP transport generally has a convective feature.The saturated RSAEs also undergo various nonlinear couplings with other collective oscillations.Two typical routes as parametric decay and modulational instability are studied using nonlinear gyrokinetic theory,and applied to the scenario of spontaneous excitation by a finite amplitude pump RSAE.Multiple RSAEs could naturally couple and induce the spectral energy cascade into a low frequency Alfvénic mode,which may effectively transfer the EP energy to fuel ions via collisionless Landau damping.Moreover,zero frequency zonal field structure could be spontaneously excited by modulation of the pump RSAE envelope,and may also lead to saturation of the pump RSAE by both scattering into stable domain and local distortion of the continuum structure.

Multidisciplinary treatment of molten aluminum combined burn:An unusual case report

Molten aluminum is among the most common causes of burns in the metal industry.However,only few reports are available on molten aluminum injuries.Herein,we report an unusual case of molten aluminum burn.The patient had burns not only on the body surface but also in the respiratory tract and esophagus,adding to the difficulty of treatment.Multidisciplinary consultation and cooperation led to the development of a treatment plan for the patient,which included tracheotomy,respiratory management,endoscopic therapy,infection control,and psychological support.To our knowledge,this is the first report of molten aluminum-induced burns involving the face,neck,respiratory tract,esophagus,and eyes.We also describe our experience with multidisciplinary treatment for the management of molten aluminum burns.

Infection control and prevention in burn victims:The role of nurses

Burn injury is a major public health concern,with an estimated 180,000 deaths each year associated with burn-related infections.The majority of these occur in low-and middle-income countries,and almost two-thirds occur in the World Health Organization African and South-East Asia Regions.There is a risk of an escalation of burn injury site infections if nurses who are directly involved in burn care do not develop a mechanism to mitigate this risk in the coming years.Hence,this study aims at explaining what burn injuries are and how nurses can prevent the occurrence of infection among burn victims.This review analyzed published studies using keywords such as burn injury,infection in burn patients,and nurses’involvement in infection prevention and control(IPC)on search engines such as PubMed,Science Direct,and Google Scholar.The literature was retrieved and reviewed for eligibility to capture just the variables indicated in this seminar objective;the date range chosen in the literature search was from 2015 to 2023.The study found that many patients die from burn injuries as a result of exposure to infection and most nurses are not adequately informed about infection control.The study also found that nurses’responsibilities include proper hand hygiene,wound care,the use of personal protective equipment,antibiotic medication,cleaning the patient’s surroundings,and preventing patient cross-contamination.Burn injuries pose a significant risk to patients,necessitating infection control and prevention.Therefore,nurses in burn units should be informed on IPC practices and also educate patients,families,and coworkers on their importance.

Angioinvasive mucormycosis in burn intensive care units:A case report and review of literature

BACKGROUND Mucormycosis is a rare,rapidly progressive and often fatal fungal infection.The rarity of the condition lends itself to unfamiliarity,delayed treatment,and poor outcomes.Diagnosis of fungal infections early enough to enable appropriate treatment occurs in less than half of affected patients.CASE SUMMARY An 11-year-old girl with a history of 15%total body surface area scald burns involving both lower limbs progressed to develop angioinvasive mucormycosis.This further led to a thrombosis of the right external iliac artery and vein and rapidly progressive necrosis of surrounding soft tissues.She also had dextrocardia and patent foramen ovale.A right hip disarticulation and serial aggressive debridements were performed but she went on to develop systemic sepsis with multisystem involvement and succumbed to the infection.Pathology revealed mucor species with extensive vascular invasion.CONCLUSION This case highlights the importance of maintaining vigilance for mycotic infections and acting appropriately when there are signs of fulminant wound infection.

Delayed Grafting as a Valid Technique in Burn Management: Experience from a Burn Unit in Oman

Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 50 years, delayed grafting as a technique for the management of burns over 15%-20% of total body surface area (TBSA) could have comparable results to that of early excision. This study aims to highlight the outcomes of practicing delayed grafting in burn patients. Methods: A case series analysis was performed of 51 patients who were admitted to the burns unit in Sultan Qaboos Hospital Salalah with over 20% TBSA between January 2014 and December 2019. The patients received prophylactic antibiotics and silver sulphadiazine dressing until the burn eschar had completely separated, followed by grafting. Results: Two patients were lost during the entire duration of the study. The mortality rate was comparable to that of early excision, while the rate of hypertrophic scarring was lower than the range reported by other studies. Conclusion: In the management of patients with over 20% TBSA, delayed grafting after complete separation of eschar is still a valid technique.

Humic Acid Effects on Reducing Corn Leaf Burn Caused by Foliar Spray of Urea-Ammonium Nitrate at Different Humic Acid/Urea-Ammonium Nitrate Ratios

Technologies for reducing corn leaf burn caused by foliar spray of urea-ammonium nitrate (UAN) during the early growing season are limited. A field experiment was carried out to evaluate the effects of humic acid on corn leaf burn caused by foliar spray of undiluted UAN solution on corn canopy at Jackson, TN in 2018. Thirteen treatments of the mixtures of UAN and humic acid were evaluated at V6 of corn with different UAN application rates and different UAN/humic acid ratios. Leaf burn during 1 2, 3, 4, 5, 6, 7, and 14 days after UAN foliar spray significantly differed between with or without humic acid addition. The addition of humic acid to UAN significantly reduced leaf burn at each UAN application rate (15, 25, and 35 gal/acre). The reduction of leaf burn was enhanced as the humic acid/UAN ratio went up from 10% to 30%. Leaf burn due to foliar application of UAN became severer with higher UAN rates. The linear regression of leaf burn 14 days after application with humic acid/UAN ratio was highly significant and negative. However, the linear regression of leaf burn 14 days after application with the UAN application rate was highly significant and positive. In conclusion, adding humic acid to foliar-applied UAN is beneficial for reducing corn leaf burn during the early growing season.

Detection of Burned Areas through Spectral Indices Analysis of Sentinel-2A Satellite Images in the Abokouamékro Wildlife Reserve (Central, Côte D’Ivoire)

In Côte d’Ivoire, the recurring and unregulated use of bushfires, which cause ecological damage, presents a pressing concern for the custodians of protected areas. This study aims to enhance our comprehension of the dynamics of burnt areas within the Abokouamékro Wildlife Reserve (AWR) by employing the analysis of spectral indices derived from satellite imagery. The research methodology began with the calculation of mean indices and their corresponding spectral sub-indices, including NDVI, SAVI, NDWI, NDMI, BAI, NBR, TCW, TCG, and TCB, utilizing data from the Sentinel-2A satellite image dated January 17, 2022. Subsequently, a fuzzy classification model was applied to these various indices and sub-indices, guided by the degree of membership α, with the goal of effectively distinguishing between burned and unburned areas. Following the classification, the accuracies of the classified indices and sub-indices were validated using the coordinates of 100 data points collected within the AWR through GPS technology. The results revealed that the overall accuracy of all indices and sub-indices declines as the degree of membership α decreases from 1 to 0. Among the mean spectral indices, NDVI-mean, SAVI-mean, NDMI-mean exhibited the highest overall accuracies, achieving 97%, 95%, and 90%, respectively. These results closely mirrored those obtained by sub-indices using band 8 (NDVI-B8, SAVI-B8, and NDMI-B8), which yield respective overall accuracies of 93%, 92%, and 89%. At a degree of membership α = 1, the estimated burned areas for the most effective indices encompassed 2144.38 hectares for NDVI-mean, 1932.14 hectares for mean SAVI-mean, and 4947.13 hectares for mean NDMI-mean. A prospective approach involving the amalgamation of these three indices could have the potential to yield improved outcomes. This study could be a substantial contribution to the discrimination of bushfires in Côte d’Ivoire.

A Preliminary Exploration of the Metrical Musicality in Robert Burns's A Red,Red Rose

The musicality of poetry is a project that has been in great need of scholars'attentions and studies due to its charming typicality,which has been a rarely-visited for a long time.To get away with this intellectual sterility and poverty,and highlight the aesthetic universality of the musicality in poetic texts,this paper aims to give a preliminary exploration of the metrical musicality in A Red,Red Rose.

The Translation and Reception of Robert Burns in China

As one of the most popular foreign poets, Robert Burns has been introduced into China since the beginning of 20th century. However the translation and acception of his works has been neglected in some scholars' research. In order to under stand the acception and influence of Burns in China, the translating and reception progress of Burns and his works will be intro duced and divided into four stages accordingly.

Free Flow-through Anterolateral Thigh Flaps for Wrist High-tension Electrical Burns:A Retrospective Case Series

Objective The objective of this report was to demonstrate the clinical application of free flow-through anterolateral thigh flaps for the treatment of high-tension electrical wrist burns.Methods We collected the data of 8 patients with high-tension electrical wrist burns admitted to Beijing Jishuitan Hospital from January 2014 to December 2018.The clinical and pathological data were extracted from electronic hospital medical records.We obtained follow-up information through clinic visits.Results The injury sites for all 8 patients were the wrists,specifically 5 right and 3 left wrists,all of which were on the flexor side.Five patients had ulnar artery embolism necrosis and patency,with injury to the radial artery.Two patients had ulnar and radial arterial embolization and necrosis.The last patient had ulnar arterial embolization and necrosis with a normal radial artery.After debridement,the wound area ranged from 12 cm×9 cm to 25 cm×16 cm.The diagnoses for the eight patients were type II to type III high-tension electrical wrist burns.Free flow-through anterolateral thigh flaps(combined with great saphenous vein transplantation if necessary)were used to repair the wounds.The prognosis for all patients was good after six months to one year of follow-up.Conclusion Treating wrist types II and III high-tension electrical burns is still challenging in clinical practice.The use of free flow-through anterolateral thigh flaps(combined with great saphenous vein transplantation if necessary)to repair the wound and to restore the blood supply for the hand at the same time is a good choice for treating severe wrist electrical burns.

Prevention and treatment of gastrointestinal dysfunction following severe burns: A summary of recent 30-year clinical experience

AIM： To sum up the recent 30-year experience in the prevention and treatment of gastrointestinal dysfunction in severe burn patients, and propose practicable guidelines for the prevention and treatment of gastrointestinal （GI） dysfunction. METHODS： From 1980 to 2007, a total of 219 patients with large area and extraordinarily large area burns （LAB） were admitted, who were classified into three stages according the therapeutic protocols used at the time： Stage 1 from 1980 to 1989, stage 2 from 1990 to 1995, and stage 3 from 1996 to 2007. The occurrence and mortality of GI dysfunction in patients of the three stages were calculated and the main causes were analyzed. RESULTS： The occurrence of stress ulcer in patients with LAB was 8.6% in stage 1, which was significantly Dower than that in stage 1 （P 〈 0.05）. No massive hemorrhage from severe stress ulcer and enterogenic infections occurred in stages 2 and 3. The occurrence of abdominal distension and stress ulcer and the mortality in stage 3 patients with extraordinarily LAB was 7.1%, 21.4% and 28.5%, respectively, which were significantly lower than those in stage 1 patients （P 〈 0.05 or P 〈 0.01）, and the occurrence of stress ulcer was also significantly lower than that in stage 2 patients （P 〈 0.05）. CONCLUSION： Comprehensive fluid resuscitation, early excision of necrotic tissue, staged food ingestion, and administration of specific nutrients are essential strategies for preventing gastrointestinal complications and lowering mortality in severely burned patients.

Long-term medical treatment of patients with severe burns at exposed sites

BACKGROUND Body parts such as the face and hands are highly exposed during daily life and burns may accumulate in these areas.In addition,residual wounds,scar hyperplasia and contracture often exist in the late stage of a deep burn in these areas,which may affect patients’appearance,movements,and mental health.However,inadequate attention has been paid to this issue which can result in problems,such as difficulty in healing,possibility of carcinoma,chronic pain and a heavy mental burden.AIM To investigate the long-term medical treatment of patients with severe burns at exposed sites following a mass burn casualty event.METHODS A retrospective analysis of 13 patients with severe burns at exposed sites was performed to determine their respective long-term medical treatment.A combined wound dressing scheme consisting of traditional Chinese and Western medicine was introduced to repair residual wounds.Active and passive functional exercises with massage,Chinese herbal baths and compression fixation were proposed to ameliorate the condition of the hands.A combination of physical,chemical and photoelectrical measures was adopted for anti-scar treatment.A psychological intervention and recovery guide was provided which corresponded to the patients’psychological status.RESULTS Compared to patients who did not simultaneously receive the same treatment,patients who underwent systematic treatment recovered with a lower woundinfection rate(P<0.05),a shorter healing time(13.6±3.2 d)compared with(19.1±3.5 d)and more bearable pain during wound dressing at three days,one week and two weeks after a Chinese herbal bath(P<0.05).Satisfactory results were achieved with regard to restored function of patients’joints and blood supply to nerve endings,closure of the eyelids and the size of mouth opening tended to be normal,and only 7.1%of patients were diagnosed with severe scar hyperplasia and contracture deformity compared with 30.7%in the control group.In addition,the color,thickness,vascular distribution and softness score of the scars improved(P<0.01),and the effects of the psychological intervention was remarkable as shown by the Self-Rating Anxiety Scale and Self-Rating Depression Scale.CONCLUSION A better prognosis can be achieved in patients in the late stage of a burn with active residual wound repair,limb functional exercise,anti-scar and psychological rehabilitation.

Potentially fatal electrolyte imbalance caused by severe hydrofluoric acid burns combined with inhalation injury: A case report

BACKGROUND Hydrofluoric acid(HF)is one of the most common causes of chemical burns.HF burns can cause wounds that deepen and progress aggressively.As a result,HF burns are often severe even if they involve a small area of the skin.Published cases of HF burns have mostly reported small HF burn areas.Few cases of HF inhalation injury have been reported to date.CASE SUMMARY A 24-year-old man suffered from extensive hydrofluoric acid burns covering 60%of the total body surface area(TBSA),including deep second degree burns on 47%and third degree burns on 13%of the TBSA,after he fell into a pickling pool containing 15%HF.Comprehensive treatments were carried out after the patient was admitted.Ventricular fibrillation occurred 9 times within the first 2 h,and the lowest serum Ca2+concentration was 0.192 mmol/L.A dose of calcium gluconate(37 g)was intravenously supplied during the first 24 h,and the total amount of calcium gluconate supplementation was 343 g.Extracorporeal membrane oxygenation(ECMO)was applied for 8 d to handle the acute respiratory distress syndrome(ARDS)induced by the HF inhalation injury.The patient was discharged after 99 d of comprehensive treatment,including skin grafting.CONCLUSION Extensive HF burns combined with an inhalation injury led to a potentially fatal electrolyte imbalance and ARDS.Adequate and timely calcium supplementation and ECMO application were the keys to successful treatment of the patient.