Burn Injury, Critical Illness, Nutritional Deficiency, Trace Element Deficiency
Conditions
Keywords
Copper, Selenium, Zinc, Continuous renal replacement therapy
Brief summary
Major burn patients are characterized by large exudative losses of Cu, Se and Zn. Trace element (TE) repletion has been shown to improve clinical outcome. The study aimed to check if our repletion protocols were achieving normalization of TE plasma concentrations of major burn patients and if the necessity for continuous renal replacement therapy (CRRT) might increase the needs.
Detailed description
Retrospective analysis of prospectively collected data in burn patients requiring intensive care (ICU) between 1999 and 2015. The cohort was divided into 4 groups according to the protocol changes. Period 1 (P1): 1999-2000, P2: 2001-2005, P3: 2006-2010, P4: 2011-2015. Changes consisted mainly in increasing TE repletion doses and duration. Demographic data, daily TE intakes and weekly plasma concentrations were retrieved for the first 21 ICU-days.
Interventions
OTHERTrace elements replacement
Sponsors
Centre Hospitalier Universitaire Vaudois
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
14 Years to 86 Years
Healthy volunteers
No
Inclusion criteria
* Burn injury involving ≥20% body surface (TBSA) (i.e. the threshold for intravenous TE repletion prescription) * At least one TE plasma concentration during the ICU stay
Exclusion criteria
* Comfort care * Admission \>24h after burn injury
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Trace elements plasma concentration | 21 days | Copper, Selenium and Zinc plasma concentrations, measured by inductively coupled plasma mass spectrometry (ICP-MS). The recommendation was to check them on a weekly basis. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of infectious complications | 21 days | Infectious complications retrieved from the discharge reports, based on microbiological findings and antibiotherapy introduction or rotation. Multiple positive cultures were considered only once when they were related to a unique infectious episode. Concomitant sites of infection, including primary bloodstream infections, were considered as separate episodes of infections. Episodes of infections due to several microorganisms were considered only once. Infections were defined according to the criteria of the Center for Disease Control (CDC), American Burn Association (ABA) and International sepsis forum. |
| Length of mechanical ventilation | Up to 120 days | Number of days on the ventilator by the time the patient is discharged from hospital. |
| Length of stay | Up to 250 days | Number of days spent in the ICU by the time the patient is discharged from hospital. |
Countries
Switzerland
Outcome results
None listed