13 research outputs found
Predicting Prognosis in Thermal Burns With Associated Inhalational Injury: A Systematic Review of Prognostic Factors in Adult Burn Victims
Prognostic values of red blood cell distribution width, platelet count, and red cell distribution width-to-platelet ratio for severe burn injury
Division of overall duration of stay into operative stay and postoperative stay improves the overall estimate as a measure of quality of outcome in burn care
Análise do lavado broncoalveolar em vĂtimas de queimaduras faciais graves Bronchoalveolar lavage analysis in victims of severe facial burns
OBJETIVO: Analisar o lavado broncoalveolar (LBA) de vĂtimas de queimaduras que inalaram fumaça a fim de identificar alterações que possam estar associadas Ă morte ou Ă sobrevida. MÉTODOS: Dezoito vĂtimas de queimaduras faciais foram submetidas a LBA atĂ© 24 h apĂłs o evento, sendo realizadas a análise do conteĂşdo celular e proteico, incluindo TNF-α, HLA-DR, CD14, CD68 e iNOS. RESULTADOS: Dos 18 pacientes submetidos Ă broncoscopia, 8 (44,4%) morreram durante o seguimento. A mĂ©dia de idade dos pacientes que morreram foi significativamente maior (44,7 vs. 31,5 anos). A superfĂcie corporal queimada foi em mĂ©dia de 60,1% nos pacientes que morreram e de 26,1% nos sobreviventes (p < 0,0001). Entre os 18 pacientes submetidos Ă broncoscopia, 11 (61,1%) apresentaram sinais endoscĂłpicos de lesĂŁo por inalação de fumaça, e 4 (36,4%) destes faleceram. Dos 7 pacientes sem sinais de lesĂŁo por inalação de fumaça, 4 (57,1%) faleceram. A mĂ©dia do nĂşmero de cĂ©lulas epiteliais ciliadas no LBA dos pacientes que morreram foi significativamente maior daquela dos sobreviventes (6,6% vs. 1,4%; p = 0,03). Os demais parâmetros analisados nĂŁo mostraram diferença entre os grupos. CONCLUSĂ•ES: A superfĂcie corporal queimada mostrou ser um fator preditivo de mortalidade. O aumento do nĂşmero de cĂ©lulas epiteliais ciliadas no LBA, denotando descamação epitelial brĂ´nquica, esteve associado Ă maior mortalidade de pacientes com queimaduras faciais.<br>OBJECTIVE: To analyze bronchoalveolar lavage (BAL) specimens of burn victims who inhaled smoke, in order to identify alterations associated with mortality or survival. METHODS: Eighteen victims of facial burns were submitted to BAL up to 24 h after the event. We investigated cell and protein content, including TNF-α, HLA-DR, CD14, CD68 and iNOS. RESULTS: Of the 18 patients submitted to bronchoscopy, 8 (44.4%) died during the follow-up period. The mean age of patients who died was significantly higher (44.7 vs. 31.5 years). On average, the patients who died had burns covering 60.1% of the total body surface area, compared with 26.1% in the survivors (p < 0.0001). Of the 18 patients submitted to bronchoscopy, 11 (61.1%) showed endoscopic signs of smoke inhalation injury, and 4 (36.4%) of those 11 died. Of the 7 patients with no signs of smoke inhalation injury, 4 (57.1%) died. The mean number of ciliated epithelial cells in the BAL fluid was significantly higher in the patients who died than in the survivors (6.6% vs. 1.4%; p = 0.03). There were no significant differences between the groups in terms of any of the other parameters evaluated. CONCLUSIONS: The total body surface area burned was a predictive factor for mortality. Increased numbers of ciliated epithelial cells in the BAL fluid, denoting bronchial epithelial desquamation, were associated with higher mortality in patients with facial burns