Chrysopoulo MT, Jeschke MG, Dziewulski P, Barrow RE, Herndon DN. Acute renal dysfunction in severely burned adults.
THE JOURNAL OF TRAUMA 1999;
46:141-4. [PMID:
9932697 DOI:
10.1097/00005373-199901000-00024]
[Citation(s) in RCA: 64] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
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.
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