Additional file 3: Table S1. Characteristics of the main clinical studies assessing the association between hemodynamics on admission and outcome in critically ill burn patients

Alexandre Mebazaa

Alice Blet

Axelle Ferry

Benjamin Deniau

Brigitte Le Cam

Charlotte Levé

Jêrome Lambert

Marc Chaouat

Matthieu Legrand

Maurice Mimoun

Maïté Chaussard

Mourad Benyamina

null null

Sabri Soussi

Véronique Maurel

PubMed

Springer - Publisher Connector

Low cardiac index and stroke volume on admission are associated with poor outcome in critically ill burn patients: a retrospective cohort study

BackgroundImpact of early systemic hemodynamic alterations and fluid resuscitation on outcome in the modern burn care remains controversial. We investigate the association between acute-phase systemic hemodynamics, timing of fluid resuscitation and outcome in critically ill burn patients.MethodsRetrospective, single-center cohort study was conducted in a university hospital. Forty critically ill burn patients with total body surface area (TBSA) burn-injured &gt;20&nbsp;% with invasive blood pressure and cardiac output monitoring (transpulmonary thermodilution technique) within 8&nbsp;h from trauma were included. We retrospectively examined hemodynamic variables during the first 24&nbsp;h following admission, and their association with 90-day mortality.ResultsThe median (interquartile range 25th-75th percentile) TBSA, Simplified Acute Physiology Score II (SAPS II) and Abbreviated Burn Severity Index of the study population were 41 (29-56), 31 (23-50) and 9 (7-11)&nbsp;%, respectively. 90-Day mortality was 42&nbsp;%. There was no statistical difference between the median pre-hospital and 24-h administered fluid volume in survivors and non-survivors. On admission, stroke volume (SV), cardiac index (CI), oxygen delivery index and mean arterial pressure (MAP) were significantly lower in patients who died despite similar fluid resuscitation volume. ROC curves comparing the ability of initial SV, CI, MAP and lactate to discriminate 90-day mortality gave areas under curves of, respectively, 0.89 (CI 0.77-1), 0.77 (CI 0.58-0.95), 0.73 (CI 0.53-0.93) and 0.78 (CI 0.63-0.92); (p value &lt;0.05 for all). In multivariate analysis, SAPS II and initial SV were independently associated with 90-day mortality (best cutoff value for SV was 27&nbsp;mL, sensitivity 92&nbsp;%, specificity 69&nbsp;%). During 24&nbsp;h, no interaction was found between time and outcome regarding macrocirculatory parameters changes. Hemodynamic parameters improved during the first 24-h resuscitation in all patients but patients who died had lower SV and CI on admission, which remained through the first 24&nbsp;h.ConclusionLow initial SV and CI were associated with poor outcome in critically ill burn patients. Very early hemodynamic monitoring may in help detecting under-resuscitated patients. Future prospective interventional studies should explore the impact of early goal-directed therapy in these specific patients

Soussi, Sabri

Deniau, Benjamin

Ferry, Axelle

Levé, Charlotte

Benyamina, Mourad

Maurel, Véronique

Chaussard, Maïté

Le Cam, Brigitte

Blet, Alice

Mimoun, Maurice

Lambert, Jêrome

Chaouat, Marc

Mebazaa, Alexandre

Legrand, Matthieu

for the PRONOBURN group

eScholarship - University of California

Additional file 2: Figure S2. The survival curve from admission to day 90

Sabri Soussi (3412004)

Benjamin Deniau (3412028)

Axelle Ferry (3412010)

Charlotte Levé (3412001)

Mourad Benyamina (3412031)

Véronique Maurel (3412016)

Maïté Chaussard (3412013)

Brigitte Le Cam (3412019)

Alice Blet (3412007)

Maurice Mimoun (3412022)

Jêrome Lambert (3412025)

Marc Chaouat (375318)

Alexandre Mebazaa (58728)

Matthieu Legrand (159626)

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MOESM2 of Low cardiac index and stroke volume on admission are associated with poor outcome in critically ill burn patients: a retrospective cohort study