Temperature profiles during resuscitation predict survival following burns complicated by smoke inhalation injury.
Temperature and resuscitation profiles of 15 non-survivors were compared with matched survivors of major burns. All patients were intubated and ventilated for smoke inhalation injury, survived more than 3 days postburn and had a cutaneous burn greater than 15 per cent of the body surface area (mean 32.3 +/- 11.0 per cent SD). Cases were matched for similar ages (within 10 years) and total body surface area burn (within 10 per cent). The rate of core temperature rise following admission to the burn unit was significantly greater in survivors (mean 0.46 +/0 0.18 degree C/h) compared with matched non-survivors (mean 0.30 +/- 0.15 degrees C/h; p < 0.01). Core temperature increased at a rate of 0.27 degrees C/h or greater in all survivors, whereas 7 non-survivors raised their core temperature at a rate less than this. The rate of skin temperature rise was also significantly greater in the survivors (mean 1.35 +/- 0.91 degrees C/h) compared with matched non-survivors (mean 0.63 +/- 0.43 degrees C/h, p < 0.01). In 13/15 survivors, the skin temperature increased at a rate of 0.6 degree C/h or greater, whereas in 8/15 non-survivors skin temperature increased at a rate less than this. There was a negative relationship between initial core temperature and delay from time of burn to admission to the burns unit in non-survivors (correlation coefficient = -0.92; p < 0.01), whereas there was no effect of delay in the survivors. These findings suggest that patients with a high mortality probability can be detected early in their clinical course by means of temperature profiles.
Platt
A J
AJ
Yorkshire-Burn Centre, Pinderfields General Hospital, Wakefield, UK.
Aslam
S
S
Judkins
K
K
Phipps
A R
AR
Smith
G L
GL
D000328:Adult; D002056:Burns / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D011237:Predictive Value of Tests; D012151:Resuscitation / Q000379:methods*; D012189:Retrospective Studies; D012867:Skin / Q000293:injuries / Q000503:physiopathology; D012881:Skin Temperature; D015208:Smoke Inhalation Injury / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D015996:Survival Rate; D016896:Treatment Outcome; D014563:Urodynamics