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Podstawski R, Borysławski K, Józefacka NM, Snarska J, Hinca B, Biernat E, Podstawska A. The influence of extreme thermal stress on the physiological and psychological characteristics of young women who sporadically use the sauna: practical implications for the safe use of the sauna. Front Public Health 2024; 11:1303804. [PMID: 38344040 PMCID: PMC10853428 DOI: 10.3389/fpubh.2023.1303804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/19/2023] [Indexed: 02/15/2024] Open
Abstract
Background Many individuals who use the sauna at a temperature of 120°C of higher are not aware of the negative consequences of extreme thermal stress. Despite extensive research into sauna use, the impact of extreme thermal stress on the physiological and psychological characteristics of sauna users have not been examined to date. Aim The aim was to determine the effect of 20 min sauna sessions with a temperature of 80°C and 120°C on the physiological and psychological characteristics of women who sporadically visit the sauna. Methods The study was conducted on 22 full-time female university students. Physical activity (PA) levels were evaluated with the Polish short version of the International Physical Activity Questionnaire (IPAQ). Anthropometric characteristics were measured before the first sauna session by the InBody270 body composition analyzer. Physiological parameters, including heart, energy expenditure, physical effort, and blood pressure (systolic blood pressure - SBP, and diastolic blood pressure - DBP), were assessed indirectly using Polar V800 heart rate monitors and the Omron M6 Comfort blood pressure monitor. The participants' wellbeing was assessed with the Profile of Mood States (POMS) questionnaire. The presence of significant correlations between heat exhaustion and heat stress variables and syncope during the second sauna session was examined with the use of classification and regression trees (CRT) and the cross-validation technique. Results Twenty-minute sauna sessions with a temperature of 80°C and 120°C induced a significant (p < 0.001) decrease in the values of SBP (excluding the temperature of 120°C), DBP, and body mass, as well as a significant increase in HR and forehead temperature. Exposure to a temperature of 80°C led to a significant (p < 0.001) increase in vigor with a simultaneous decrease in tension, depression, anger, fatigue, and confusion. In turn, sauna bathing at a temperature of 120°C had an opposite effect on the above mood parameters. Vomiting and confusion were the main predictors of syncope that occurred in some of the surveyed women. Conclusion Excessive air temperature can induce symptoms characteristic of heat exhaustion and heat stress nausea, heavy sweating, fast weak or strong HR, high body temperature, and confusion. Therefore, sauna bathing at a temperature of 80°C can be recommended to women who sporadically use the sauna, whereas exposure to a temperature of 120°C is not advised in this group of sauna users. The present findings provide highly valuable inputs for managing wellness and SPA centers.
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Affiliation(s)
- Robert Podstawski
- School of Public Health, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Krzysztof Borysławski
- Angelus Silesius University of Applied Sciences, Institute of Health, Wałbrzych, Poland
| | | | - Jadwiga Snarska
- School of Public Health, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Bożena Hinca
- Department of Physical Education and Sport, University of Gdańsk, Gdańsk, Poland
| | - Elżbieta Biernat
- Collegium of World Economy, SGH Warsaw School of Economics, Warsaw, Poland
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Kaiser P, Seeher U, Krasniqi A, Keiler A, Crazzolara R, Meryk A. Injuries related to sauna bathing. Injury 2023:110825. [PMID: 37211472 DOI: 10.1016/j.injury.2023.05.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 05/08/2023] [Accepted: 05/13/2023] [Indexed: 05/23/2023]
Abstract
PURPOSE Awareness of well-being and health issues have contributed to increased popularity of sauna bathing. However, little is known about potential risks and injuries. The aim of this study was to identify the causes for injuries, the affected body regions and to define recommendations for prevention. METHODS A retrospective chart data analysis was conducted among patients treated for an injury related to sauna bathing at the local trauma centre of the Medical University of Innsbruck between January 1, 2005 and December 31, 2021. Patients' demographics, the cause for the injury, the diagnosis, the body region of the trauma and the treatment methods were collected. RESULTS Two hundred and nine patients with injuries related to sauna bathing (83 female [39.7%] and 126 male [60.3%]) were identified. Fifty-one patients showed more than one injuries leading to a total of 274 diagnosis: contusions/distorsions (113; 41.2%), wounds (79; 28.8%), fractures (42; 15.3%), ligament injuries (17; 6.2%), concussions (15; 5.5%), burns (4; 1.5%) and brain bleeding (3; 1.1%). The most common cause for an injury was a slip/fall (157; 57.5%) followed by dizziness/syncope (82; 30.0%). Interestingly, head and face injuries were mostly caused by dizziness/syncope, whereas slip/fall was the leading cause for injuries of foot, hand, forearm and wrist. Nine patients(4.3%) needed surgical treatment mainly due to fractures. Eight patients got injured by wood splinters. One patient sustained grade IIB-III burns lying unconscious with an alcohol intoxication of 3.6‰ in the sauna. CONCLUSION The main causes for injuries during sauna bathing were slip/falls and dizziness/syncopes. The latter one might be prevented by improved of the personal behaviour (e.g. drink enough water before and after each sauna bathing), whereas slip/falls might be prevented by the revision of safety regulations, particularly the obligation to wear slip resistant slippers. Thus, everyone himself as well as the operators can contribute to reduce injuries related sauna bathing.
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Affiliation(s)
- Peter Kaiser
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Austria
| | - Ulrike Seeher
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Austria
| | - Arbnor Krasniqi
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Austria
| | - Alexander Keiler
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Austria
| | - Roman Crazzolara
- Department of Pediatrics, Medical University of Innsbruck, Anichstr. 35, Innsbruck 6020, Austria
| | - Andreas Meryk
- Department of Pediatrics, Medical University of Innsbruck, Anichstr. 35, Innsbruck 6020, Austria.
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Reyes-Illg G, Martin JE, Mani I, Reynolds J, Kipperman B. The Rise of Heatstroke as a Method of Depopulating Pigs and Poultry: Implications for the US Veterinary Profession. Animals (Basel) 2022; 13:140. [PMID: 36611748 PMCID: PMC9817707 DOI: 10.3390/ani13010140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
Depopulation of food-producing animals is becoming increasingly common in response to both disease outbreaks and supply chain disruptions. In 2019, the American Veterinary Medical Association released depopulation guidelines classifying certain heatstroke-based killing methods as "permitted in constrained circumstances", when circumstances of the emergency constrain reasonable implementation of "preferred" methods. Since then, tens of millions of birds and pigs have been killed by such methods, termed ventilation shutdown (VSD) Plus Heat and VSD Plus High Temperature and Humidity. While no research using validated measures of animal welfare assessment has been performed on these methods, their pathophysiology suggests that animals are likely to experience pain, anxiety, nausea, and heat distress prior to loss of consciousness. Heatstroke-based methods may result in prolonged suffering and often do not achieve 100% mortality. Potential and available alternative depopulation methods are briefly reviewed. The veterinary profession's ethical obligation to protect animal welfare in the context of depopulations is discussed.
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Affiliation(s)
| | - Jessica E. Martin
- School of Natural and Environmental Sciences, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
| | | | - James Reynolds
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA 91766, USA
| | - Barry Kipperman
- School of Veterinary Medicine, University of California, Davis, CA 95616, USA
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Correlations between Repeated Use of Dry Sauna for 4 x 10 Minutes, Physiological Parameters, Anthropometric Features, and Body Composition in Young Sedentary and Overweight Men: Health Implications. BIOMED RESEARCH INTERNATIONAL 2019; 2019:7535140. [PMID: 30800676 PMCID: PMC6360547 DOI: 10.1155/2019/7535140] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 12/25/2018] [Indexed: 02/03/2023]
Abstract
Background The effect of thermal stress on the physiological parameters of young overweight and sedentary men who sporadically use the sauna remains insufficiently investigated. Aim The aim of the study was to determine the effect of sauna bathing on the physiological parameters of young overweight, physically inactive men and to test the correlations between physiological parameters versus anthropometric features and body composition parameters. Materials and Methods Forty-five overweight and sedentary men aged 20.76±2.4 y were exposed to four sauna sessions of 10 minutes each (temperature: 90-91°C; relative humidity: 14-16 %) with four 5-minute cool-down breaks. Body composition was determined before sauna, and body mass and blood pressure were measured before and after sauna. Physiological parameters were monitored during four 10-minute sauna sessions. Results A significant (p<0.0001) increase in all analyzed physiological parameters was observed during four successive 10-minute sauna sessions. Heart rate, energy expenditure, blood pressure, and body mass loss were most strongly correlated with anthropometric parameters (body mass, body mass index, and body surface area) and body composition parameters (percent body fat, body fat mass, and visceral fat level). The 60-minute treatment resulted in a significant reduction in body mass (0.65 kg). Conclusions Repeated use of Finnish sauna induces significant changes in the physiological parameters of young sedentary overweight men, and these changes are intensified during successive treatments. Deleterious cardiovascular adaptations were most prevalent in men characterized by the highest degree of obesity and the largest body size.
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Rakkolainen I, Lindbohm JV, Vuola J. Factors associated with acute kidney injury in the Helsinki Burn Centre in 2006-2015. Scand J Trauma Resusc Emerg Med 2018; 26:105. [PMID: 30545389 PMCID: PMC6293617 DOI: 10.1186/s13049-018-0573-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 11/29/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Acute kidney injury (AKI) is a common complication in severe burns and can lead to significantly poorer outcomes. Although the prognosis has improved in recent decades, the mortality of AKI remains considerable. We investigated the factors that increase the risk of AKI and death after severe burn injury. METHODS Intensive care patients with ≥20% burned total body surface area (TBSA%) between January 2006 and December 2015 treated in Helsinki Burn Centre were enrolled retrospectively. Patients who arrived > 36 h after burn injury or died < 48 h from arrival were excluded. A total of 187 patients were included in the final analysis. Serum creatinine ≥120 μmol/l (1.4 mg/dl) was the criterion for AKI. RESULTS Fifty-one patients (27.3%) developed AKI during hospital stay and 21 (11.2%) required renal replacement therapy (RRT); 37 patients (19.8%) died during hospital stay. Mortality was significantly higher in the AKI group (52.9%) than in the AKI-negative group (7.4%). The Abbreviated Burn Severity Index (ABSI), Baux, and the modified Baux score were nearly equivalent in predicting mortality during ICU stay (AUC: 0.83-0.84). The risk of death and AKI were minimal with Baux scores < 80. LD50 was 112 for Baux score in all patients. In flame burns, the risk of death increased rapidly after Baux score > 80. Multivariate logistic regression model detected age, TBSA%, sepsis, and rhabdomyolysis as independent risk factors for AKI. Age (per 10 yrs. OR 1.99), TBSA% (per 10% OR 1.64), and AKI predicted mortality during hospital stay; AKI had an odds ratio of (OR) of 5.97 (95% confidence interval [CI] 2.2-16.2). CONCLUSIONS Age, TBSA%, and AKI were the strongest independent factors in predicting outcome in severe burns. Even a major burn (> 50% TBSA) has a relatively good prognosis without simultaneous AKI. Prognosis is poorer even in minor burns for patients with AKI.
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Affiliation(s)
- I Rakkolainen
- Helsinki Burn Centre, Department of Plastic Surgery, Helsinki University Hospital and University of Helsinki, PO. Box 800, FI-00029 HUS, Helsinki, Finland.
| | - J V Lindbohm
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - J Vuola
- Helsinki Burn Centre, Department of Plastic Surgery, Helsinki University Hospital and University of Helsinki, PO. Box 800, FI-00029 HUS, Helsinki, Finland
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Strandberg TE, Strandberg A, Pitkälä K, Benetos A. Sauna bathing, health, and quality of life among octogenarian men: the Helsinki Businessmen Study. Aging Clin Exp Res 2018; 30:1053-1057. [PMID: 29188579 DOI: 10.1007/s40520-017-0855-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 11/07/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIM Sauna-type bathing has increased worldwide, and it has been related to both harmful and beneficial effects. There are few studies of bathing in sauna in very old age. METHODS The series consists of 524 mostly home-living survivors of the Helsinki Businessmen Study (HBS, mean age 86 years, range 80-95), who in 2015 responded to a questionnaire survey about lifestyle (including sauna bathing), prevalent diseases, and health-related quality of life (HRQoL, RAND-36). RESULTS Of the men 57.6% (n = 302) reported all-year round and 17.6% (n = 92) part-year sauna bathing. Sauna was currently used mostly once a week, but 10% bathed more than twice a week. Median time in the hot room was 15 min at 80 °C. Among 45.7% of the men, the habit had decreased with ageing, and 130 (24.8%) did not attend sauna. However, 92.2% of the latter had discontinued an earlier habit, respective proportions 20.7% and 75.0% among all-year and part-year users. Overall, reasons for decreased sauna bathing were nonspecific or related to mobility problems or diverse health reasons (n = 63). The most frequent motivations for sauna were relaxation and hygienic reasons. Of the RAND-36 domains physical function, vitality, social functioning, and general health were significantly better among sauna users than non-users. These differences partly remained after adjusting for prevalent diseases and mobility-disability. CONCLUSIONS Regular sauna bathing was common among octogenarian men and was associated with better HRQoL. However, reverse causality must be taken into account in this cross-sectional study. The bathing habit seemed to be prudent and had decreased in almost half of the cohort.
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Affiliation(s)
- Timo E Strandberg
- University of Helsinki, Clinicum, and Helsinki University Hospital, Haartmaninkatu 4, PO Box 340, 00029, Helsinki, Finland.
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.
| | - Arto Strandberg
- University of Helsinki, Clinicum, and Helsinki University Hospital, Haartmaninkatu 4, PO Box 340, 00029, Helsinki, Finland
| | - Kaisu Pitkälä
- University of Helsinki, Clinicum, and Helsinki University Hospital, Haartmaninkatu 4, PO Box 340, 00029, Helsinki, Finland
| | - Athanase Benetos
- University Hospital of Nancy, Université de Lorraine, Nancy, France
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Clinical Effects of Regular Dry Sauna Bathing: A Systematic Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:1857413. [PMID: 29849692 PMCID: PMC5941775 DOI: 10.1155/2018/1857413] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/14/2017] [Accepted: 01/08/2018] [Indexed: 12/13/2022]
Abstract
Introduction Many health benefits are claimed by individuals and facilities promoting sauna bathing; however the medical evidence to support these claims is not well established. This paper aims to systematically review recent research on the effects of repeated dry sauna interventions on human health. Methods A systematic search was made of medical databases for studies reporting on the health effects of regular dry sauna bathing on humans from 2000 onwards. Risk of bias was assessed according to the Cochrane Collaboration guidelines. Results Forty clinical studies involving a total of 3855 participants met the inclusion criteria. Only 13 studies were randomized controlled trials and most studies were small (n < 40). Reported outcome measures were heterogeneous with most studies reporting beneficial health effects. Only one small study (n = 10) reported an adverse health outcome of disrupted male spermatogenesis, demonstrated to be reversible when ceasing sauna activity. Conclusions Regular dry sauna bathing has potential health benefits. More data of higher quality is needed on the frequency and extent of adverse side effects. Further study is also needed to determine the optimal frequency and duration of distinct types of sauna bathing for targeted health effects and the specific clinical populations who are most likely to benefit.
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Choi H, Lee J, Song J. Steam burn on nose by heated, humidified high-flow nasal cannula in neonate. Int Wound J 2016; 13:1087-8. [PMID: 27000747 DOI: 10.1111/iwj.12584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 02/11/2016] [Indexed: 11/28/2022] Open
Affiliation(s)
- Hwanjun Choi
- Department of Plastic and Reconstructive Surgery, Soonchunhyang University, Chungcheongnam-do, Korea.
| | - Junho Lee
- Department of Plastic and Reconstructive Surgery, Soonchunhyang University, Chungcheongnam-do, Korea
| | - Junhwan Song
- Department of Pediatrics, Neonatology, College of Medicine, Soonchunhyang University, Chungcheongnam-do, Korea
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Helanterä I, Koljonen V, Finne P, Tukiainen E, Gissler M. The risk for end-stage renal disease is increased after burn. Burns 2016; 42:316-21. [DOI: 10.1016/j.burns.2015.10.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 09/27/2015] [Accepted: 10/26/2015] [Indexed: 11/29/2022]
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Sudden Death in Sauna Due to Fatal Burns: A Case Report. Am J Forensic Med Pathol 2015; 37:1-3. [PMID: 26566054 DOI: 10.1097/paf.0000000000000208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Sudden death during or after sauna bathing is a rare event. When occurring accidentally, it is often caused or contributed by consumption of ethanol. To accidentally burn to death because of hot air is highly uncommon without some contributing factor that lowers the person's consciousness. Hot air burns have been reported to develop in 20 to 60 minutes. We present a case of sudden death of a healthy man with rare and extensive hot air burns that developed in less than 10 minutes in the sauna. Ethanol was not a contributing factor. Substantial injuries were found at the autopsy, both external and internal, for instance, small hemorrhages in the stomach mucosa, indicating a heavy antemortem stress reaction. The most probable reason for the extensive scalds was concluded to be, apart from the high temperature, the high degree of relative humidity in the sauna.
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Abstract
A 70-year-old woman visited a Korean-style hot dry sauna room. The patient had a medical history of hypertension and hyperlipidemia. During the sauna, the patient slept for 30 minutes. During the sleep, the right medial thigh was covered with a fully wet towel. The patient sustained a second-degree burn on the right medial thigh area with multiple bullas. On physical examination, erythema, heating sensation, and swelling around the bullas were noted. The patient was admitted and received intravenous antibiotics for 7 days. A dressing with Silmazine 1% cream (sulfadiazine) was applied twice a day for prevention of local infection. The patient was discharged on day 14 without complication. In this case, the mechanism of the burn was different. Hot air has much thermal energy but is not conducted to the skin directly. A wet towel will have a relatively higher thermal capacity or heat capacity than a dry or damp towel, and the sodden water might be a medium for the conduction of thermal energy. Owing to the global popularity of sauna bathing, it is important to recognize all sources of sauna-related burns.
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Late-onset rhabdomyolysis in burn patients in the intensive care unit. Burns 2011; 37:1241-7. [PMID: 21703770 DOI: 10.1016/j.burns.2011.05.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 05/13/2011] [Accepted: 05/24/2011] [Indexed: 11/20/2022]
Abstract
Rhabdomyolysis (RML), defined as creatine phosphokinase (CPK) >1000 U/L, is relatively common immediately after a significant burn. Late-onset RML, occurring a week or more after a burn, is less well understood and recognised. All patients admitted to the Intensive Care Unit (ICU) following an acute burn between May 2006 and December 2009 were retrospectively identified. Patients with CPK>1000 U/L a week or more after their burn had a detailed notes review. Seventy-six patients were admitted during 43 months. Late-onset RML was demonstrated in 7/76 (9%) patients. They had a similar pattern of normal or mildly raised CPK on admission that resolved over the following days, but suddenly increased sharply to over 1000 U/L, a week or more after their burn, usually around day ten. A severe late-onset RML occurred in 5/76 (7%) patients, with a CPK rise of over 5000 U/L, and all required haemodialysis. Potential triggering factors for late-onset RML include sepsis, nephrotoxic drugs and hypophosphataemia. It is important to consider measuring CPK in all patients with the above complications, even after it has previously been observed to be normal, in order to initiate early treatment.
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Stollwerck PL, Namdar T, Stang FH, Lange T, Mailänder P, Siemers F. Rhabdomyolysis and acute renal failure in severely burned patients. Burns 2010; 37:240-8. [PMID: 20965664 DOI: 10.1016/j.burns.2010.09.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Revised: 08/01/2010] [Accepted: 09/14/2010] [Indexed: 01/12/2023]
Abstract
Rhabdomyolysis (RML) is a precarious complication in severely burned patients and the principal treatment goal is prevention of acute renal failure (ARF). This 10-year retrospective study analyses the causes for RML in severely burned patients and evaluates treatment algorithms. Eight of 714 patients (1%) were diagnosed with RML. Percentage TBSA burn was 25 ± 13%. The mean abbreviated burn severity index score (ABSI) was 9 ± 2. ARF was found in 75% (6/8) of the patients. Serum myoglobin (MB) was reduced by 41 ± 16% after 24-h treatment by solitary volume repletion (VR) and by 44 ± 20% through VR+continuous veno-venous hemodiafiltration (CVVHDF). Mortality was 50% (4/8). Peak mean CPK-levels were more than two and MB-levels more than four times higher in non-survivors than in survivors. Burns associated with RML result in poor survival. VR and CVVHDF are effective measures in treating RML. CVVHDF is effective in removing MB when using high flux filter membranes. Early CVVHDF (within 24h of diagnosis) with high-cut off membranes could reduce the risk of ARF and mortality.
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Affiliation(s)
- Peter L Stollwerck
- Plastic Surgery, Hand Surgery, Burns Unit, University Hospital Schleswig-Holstein Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany.
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