BACKGROUND: Factors contributing to mortality in burned children with acute renal failure have been identified; however, they have not been identified in thermally injured adults. METHODS: The records of 1,404 acutely burned adults admitted to the Blocker Burn Unit were reviewed. Seventy-six patients with acute renal dysfunction and burns covering more than 30% of their total body surface area with a full-thickness component greater than 10% total body surface area were identified. These patients were divided into those admitted from 1981 through 1989 (n = 35) and those admitted from 1990 to 1998 (n = 41). RESULTS: No significant differences could be shown in the incidence of acute renal dysfunction (5.4 vs. 5.1%) or mortality (88 vs. 87%) for the two time periods, respectively. Sixty-seven percent of the survivors were younger than 40 years of age, compared with only 25% of nonsurvivors (p < 0.02); sepsis was identified in 44 and 96% of survivors and nonsurvivors, respectively (p < 0.001). Fluid resuscitation was delayed in survivors by 1.7+/-1.0 hours compared with 4.4+/-2.1 hours in nonsurvivors (p < 0.001). CONCLUSION: early fluid resuscitation and the prevention of sepsis may reduce the incidence of acute renal dysfunction and mortality in burned adults.
BACKGROUND: Factors contributing to mortality in burned children with acute renal failure have been identified; however, they have not been identified in thermally injured adults. METHODS: The records of 1,404 acutely burned adults admitted to the Blocker Burn Unit were reviewed. Seventy-six patients with acute renal dysfunction and burns covering more than 30% of their total body surface area with a full-thickness component greater than 10% total body surface area were identified. These patients were divided into those admitted from 1981 through 1989 (n = 35) and those admitted from 1990 to 1998 (n = 41). RESULTS: No significant differences could be shown in the incidence of acute renal dysfunction (5.4 vs. 5.1%) or mortality (88 vs. 87%) for the two time periods, respectively. Sixty-seven percent of the survivors were younger than 40 years of age, compared with only 25% of nonsurvivors (p < 0.02); sepsis was identified in 44 and 96% of survivors and nonsurvivors, respectively (p < 0.001). Fluid resuscitation was delayed in survivors by 1.7+/-1.0 hours compared with 4.4+/-2.1 hours in nonsurvivors (p < 0.001). CONCLUSION: early fluid resuscitation and the prevention of sepsis may reduce the incidence of acute renal dysfunction and mortality in burned adults.
Authors: Nele Brusselaers; Stan Monstrey; Kirsten Colpaert; Johan Decruyenaere; Stijn I Blot; Eric A J Hoste Journal: Intensive Care Med Date: 2010-03-24 Impact factor: 17.440
Authors: David F Schneider; Adrian Dobrowolsky; Irshad A Shakir; James M Sinacore; Michael J Mosier; Richard L Gamelli Journal: J Burn Care Res Date: 2012 Mar-Apr Impact factor: 1.845
Authors: Robert Kraft; David N Herndon; Ludwik K Branski; Celeste C Finnerty; Katrina R Leonard; Marc G Jeschke Journal: J Surg Res Date: 2012-06-06 Impact factor: 2.192
Authors: Kevin K Chung; Jonathan B Lundy; James R Matson; Evan M Renz; Christopher E White; Booker T King; David J Barillo; John A Jones; Leopoldo C Cancio; Lorne H Blackbourne; Steven E Wolf Journal: Crit Care Date: 2009-05-01 Impact factor: 9.097