Model System:

Burn

Reference Type:

Journal

Accession No.:

J73530

Journal:


Annals of Surgery

Year, Volume, Issue, Page(s):

, 259, 4, 814-823

Publication Website:

Abstract:

Study explored whether trajectories of common biomedical markers of metabolism and inflammation can be utilized to determine survival in pediatric burn patients. A total of 230 severely burned children with burns exceeding 30 percent of their total body surface, requiring at least 1 surgical procedure were enrolled in this study; 79 died within 300 days of the burn injury. Demographics, clinical outcomes, and inflammatory and acute-phase responses (serum cytokines, hormones, and proteins) were determined at admission and at 11 time points for up to 180 days post burn. Statistical analysis was performed using a 1-way analysis of variance, the Student t test, chi-squared test, and Mann-Whitney test where appropriate. Survivors and non-survivors exhibited profound differences in critical markers of inflammation and metabolism at each time point. Non-survivors had significantly higher serum levels of interleukin (IL)-6, IL-8, granulocyte colony-stimulating factor, monocyte chemoattractant protein-1, C-reactive protein, glucose, insulin, blood urea nitrogen, creatinine, and bilirubin. Furthermore, non-survivors exhibited a vastly increased hypermetabolic response that was associated with increases in organ dysfunction and sepsis when compared with survivors. The results indicate that non-survivors have different trajectories in inflammatory, metabolic, and acute phase responses that differentiate them from survivors and may allow predictive models to improve and personalize burn outcomes.

Author(s):


Jeschke, Marc G., Gauglitz, Gerd G., Finnerty, Celeste C., Kraft, Robert, Mlcak, Ronald P., Herndon, David N.

Participating Centers: