Prognosis of patients with severe burns based on plasma base excess and serum lactate level and comparison with ABSI

Background and Aim: This study was aimed to evaluate the prognosis of patients with severe burns by measuring the plasma base excess and serum lactate levels and comparing it with the ABSI scoring system as an important indicator in the resuscitation of burn patients.Methods: This prospective cohort study was performed on all patients hospitalized in the burn ward of the hospital. The demographic data and ABSI scoring of all patients were recorded. Patients' clinical information and routine tests, gasometry (for measuring plasma base excess) and serum lactate levels were measured at the time of admission, 12 hours, and 24 hours after admission.Results: A total of 311 burning patients were evaluated in this study. Mann-Whitney test showed a significant difference in the mean plasma BE1 (at the time of admission) and BE2 (24 hours after admission) between the patients who were discharged and the patients who died (P <0.001). The results indicated a difference in the process of lactate changes between two groups of patients in terms of intensity of ABSI(P <0.001). The multivariate logistic regression with the entry of BE and lactate at the time of admission and ABSI as predictive variables indicated a significant BE and ABSI.Conclusion: The results of this study confirmed that the plasma base excess can be used as a valuable tool in the monitoring of burn patients' resuscitation along with clinical criteria. On the other hand, the ABSI scoring system is still a valuable tool to predict the deaths of burn patients

The Nutritional Status of Patients Hospitalized in the ICUs of Iranian Hospitals: A Systematic Review

Background: Malnutrition is so common among hospitalized patients, especially those in intensive care units (ICUs). Providing adequate nutritional support for these patients is of utmost significance.Aim: The present study was conducted with aim to investigate the nutritional status of patients hospitalized in the ICUs of Iranian hospitals.Method: This systematic review was performed according to recommendations from the Cochrane Handbook. A search was conducted on Medline, Web of Sciences, PubMed, Scopus, and SID databases to find the articles on nutritional support for ICU patients hospitalized in Iran until April 9, 2023, using the keywords of "intensive care unit" OR "ICU" AND "nutritional support" and "Iran".Results: Finally, 19 original, cross-sectional, prospective cohort, and retrospective articles conducted on human samples were entered in this study. Except for one study, all articles reported that the dietary intake was significantly lower among ICU admitted patients. Nutrition Risk in Critically Ill score, Acute Physiology and Chronic Health Evaluation (APACHE II), Nutritional Risk Screening-2002 (NRS), and Subjective Global Assessment (SGA) measurement tools were used to predict the rate of malnutrition among the patients. Recorded reports indicate low calorie and nutrient intake among patients during ICU stay.Implications for Practice: The analyzed hospitals have unsuitable and inadequate nutritional care services. In addition, the patient's intake of calories, protein, and other daily nutrients was significantly lower than the recommended amount leading to a cascade of undesirable patient outcomes

Five years of a single burn center experience with toxic epidermal necrolysis: retrospective study of causative drugs and the clinical outcome

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, but potentially life-threatening reactions to medications. Both conditions have significant morbidity and mortality. This study aimed to document the epidemiological features, aetiologies, treatment and clinical outcomes of such patients.Method: In this retrospective cross-sectional study the records of all patients with TEN treated for5 years in central Hospital, Mashhad, Iran were reviewed. Results: Thirty-four patients were studied with a mean age of 26.5 years. Mean age in the mortality and survivors groups was 33.6 and 25.3 years, respectively. Drugs accounted for all 34 cases were including Anti-convulsants (52.9%) other the most common implicated drug followed by antibiotics (26.5%), allopurinol (5.9%) and multiple drugs (anticonvulsants plus antibiotics) (14.7%). Antibiotics had the shortest interval between ingestion time and onset of symptoms. The mean ICU length of stay was 12.7 days, with a range of 1 to 30 days. The mean of SCORTEN was 2.3; it was 3.3 and 2.1 in the mortality and survivors group, respectively (P=0.001).All 34 TEN cases were given intravenous immunoglobulins (IVIG). Six patients with TEN died (17.6%). The highest mortality was found in the allopurinol group with 50%, whereas anticonvulsants and antibiotics had a mortality rate of 16.6% and 15.3%, respectively.Conclusion: Anti-convulsants especially Lamotrigine were the most frequently implicated drug, followed by antibiotics and allopurinol. IVIG was shown beneficial effects in TEN syndrome