Burns : journal of the International Society for Burn Injuries
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Observational Study
PenKid measurement at admission is associated with outcome in severely ill burn patients.
Proenkephalin A 119-159 (penKid) has been proposed as a sensitive biomarker of renal function. This study evaluated the association of concentrations of plasma penKid with death and risk of acute kidney injury (AKI) in severely ill burn patients. ⋯ Plasma penKid concentration at admission was associated with an increased risk of death in burn patients. PenKid has additional prognostic value on top of Screat and SOFA to predict 90-day mortality.
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The development of acute outpatient clinics has enabled burns services to assess the majority of smaller paediatric burns the day after injury. This event can be distressing and it is therefore important to ensure that children are initially assessed in an optimal environment. ⋯ This national survey has shown that 5% total body surface area (TBSA) is generally considered to be the upper limit for new paediatric referrals to be seen in the outpatient setting 5%. Furthermore, we advocate that Paracetamol and Ibuprofen be given 60 min prior to an allocated appointment time.
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The Abbreviated Burn Severity Index (ABSI) is a widely used and simple score to predict mortality after burn injuries. On the one hand, significant improvements in intensive care management and surgical treatment result in an increased survival rate. On the other hand, the aging population might lead to an increased injury-related mortality rate. Therefore, the question arises whether the ABSI still accurately predicts survival. ⋯ The ABSI does not accurately predict probability of survival. Mortality is overestimated in severely burned patients. A modified version was developed that was significantly more accurate in predicting the probability of survival in this cohort.
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Burn wounds continue to worsen after initial injury in a process known as burn conversion, which lasts about 3-5 days. It causes burn wounds to enlarge and deepen, leading to greater morbidity. Apoptosis is one of the factors contributing to the conversion of the zone of stasis into the zone of coagulation. Suppression of apoptosis has been associated with reducing burn conversion. Connexin 43 (Cx43) gap junctions facilitate the spread of apoptotic signals from dying cells to healthy neighbouring cells in injured tissues through the bystander effect. ⋯ Our findings suggest that elevation of Cx43 may play an active role in burn conversion spreading apoptosis in the early and intermediate burn wound.