Academic Journal
290 Admission Inflammatory Cytokine Levels Are Predictive of Fluid Resuscitation Requirements in Thermally Injured Patients
| العنوان: | 290 Admission Inflammatory Cytokine Levels Are Predictive of Fluid Resuscitation Requirements in Thermally Injured Patients |
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| المؤلفون: | Kelly, Edward J, Carney, Bonnie C, Keyloun, John, Moffatt, Lauren T, Shupp, Jeffrey W, Tejiram, Shawn |
| المصدر: | Journal of Burn Care & Research ; volume 44, issue Supplement_2, page S186-S186 ; ISSN 1559-047X 1559-0488 |
| بيانات النشر: | Oxford University Press (OUP) |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | Rehabilitation, Emergency Medicine, Surgery |
| الوصف: | Introduction Resuscitation of patients with major thermal injury is accomplished with crystalloid infusion-based injury size and patient weight ultimately titrated based on patient response. Estimations of fluid requirements can be imprecise and predicting responsiveness lacks precision. Previous work has demonstrated perturbations in both proinflammatory and anti-inflammatory cytokines in burn patients. However, there is a paucity of literature examining the impact of these perturbations and their usefullness to help predict resuscitation needs. This study sought to examine patient specific cytokine levels which may provide better insight into resuscitation requirements. Methods Burn injured patients presenting to a regional center over six years were prospectively enrolled in this observational clinical trial. Blood samples were collected on admission. Plasma cytokine levels (IL-1b, IL-6, IL-10, IL-12p70 and TNF-a) were quantified by ELISA. Crystalloid resuscitation volumes during the first 48 hours were assessed for correlation with cytokine levels after adjusting for weight and %TBSA. Results Thirty-eight patients were included in the analysis. Mean total body surface area (TBSA) burned was 26.7±14.4%. Elevated levels of IL-6 significantly correlated with normalized resuscitation volumes (ml/kg/%TBSA) from 8-24hrs and 24-48hrs (r=0.52, p< 0.001; r=0.41, p< 0.01). Elevated levels of IL-10 were also significantly correlated with normalized crystalloid volumes from 8-24hrs and 24-48hrs (r=0.55, p< .01; r=0.46, p< 0.001). Elevated levels of TNF-a also correlated with normalized crystalloid volumes from 8-24hrs and 24-48hrs (r=0.60, p< 0.0001; r=0.57, p< 0.001). Conclusions Predicting resuscitation volumes (and preventing over excessive crystalloid administration—fluid creep) is an integral aspect of burn injury management and there is a need for more objective methods for measurement. Phenotyping patients based on admission cytokine levels employing point of ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1093/jbcr/irad045.265 |
| الاتاحة: | http://dx.doi.org/10.1093/jbcr/irad045.265 https://academic.oup.com/jbcr/article-pdf/44/Supplement_2/S186/51286949/irad045.265.pdf |
| Rights: | https://creativecommons.org/licenses/by/4.0/ |
| رقم الانضمام: | edsbas.6EA1755F |
| قاعدة البيانات: | BASE |
| DOI: | 10.1093/jbcr/irad045.265 |
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