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Is there a difference in clinical outcomes, inflammation, and hypermetabolism between scald and flame burn?
| Content Provider | Scilit |
|---|---|
| Author | Kraft, Robert Kulp, Gabriela A. Herndon, David N. Emdad, Fatemah Williams, Felicia N. Hawkins, Hal K. Leonard, Katrina R. Jeschke, Marc G. |
| Copyright Year | 2011 |
| Description | Journal: Pediatric Critical Care Medicine |
| Abstract | Objective: Severe thermal injury induces inflammatory and hypermetabolic responses that are associated with morbidity and mortality. However, it is not well-documented whether the causes of burns affect inflammation, hypermetabolism, and morbidity. The aim of the present study was to determine whether there is a difference in degree of inflammation, hypermetabolism, endocrine and acute-phase response, and clinical outcome between pediatric patients with scald and flame burns. Interventions: None. Measurements and Main Results: Children with burns requiring surgical intervention were enrolled in this cohort study and divided into two groups, scald or flame burn. In a second assignment, we analyzed the study populations in representative subgroups containing individuals with third-degree burns of 40% to 60% total body surface area. We determined clinical outcomes, resting energy expenditures, cytokine profiles, acute-phase proteins, constitutive proteins, and hormone panels. Statistical analysis was evaluated by analysis of variance, Student's t test corrected with the Bonferroni post hoc test, and the propensity score. Statistical significance was set at p < .05. A total of 912 patients were identified. Six hundred seventy-four had a flame burn and 238 had a scald burn. There was a significant difference (p < .05) in burn size (flame, 48% ± 23%; scald, 40% ± 21%), third-degree burn (flame, 39% ± 27%; scald 22% ± 25%), age (flame, 8 ± 5 yrs; scald, 3 ± 3 yrs), and mortality between groups. Propensity analysis confirmed the type of burn as a significant risk factor for morbidity and mortality. Subanalysis conducted in a representative patient group suffering from 40% to 60% burn total body surface area revealed that flame burns lead to significantly increased hypermetabolic, inflammatory, and acute-phase responses when compared to scald burns (p < .05). The frequency of sepsis was 3% in the scald burn group, while it was 14% in the flame group (p < .001). Multiorgan failure occurred in 14% of the scald patients, while it occurred in 17% of flame patients. The mortality in patients suffering from a scald burn was 3% compared to 6% in the flame-burned group (p < .05). Conclusion: The type of burn affects hypermetabolism, inflammation, acute-phase responses, and mortality postburn. |
| Related Links | http://europepmc.org/articles/pmc3672859?pdf=render https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672859/pdf |
| Ending Page | e281 |
| Page Count | 7 |
| Starting Page | e275 |
| ISSN | 15297535 |
| DOI | 10.1097/pcc.0b013e31820ac2c5 |
| Journal | Pediatric Critical Care Medicine |
| Issue Number | 6 |
| Volume Number | 12 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2011-11-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Pediatric Critical Care Medicine Otorhinolaryngology Pediatrics and Child Health |
| Content Type | Text |
| Resource Type | Article |
| Subject | Critical Care and Intensive Care Medicine Pediatrics, Perinatology and Child Health |
