[An early comprehensive prevention and treatment of sepsis in severely burned patients with delayed fluid resuscitation].
OBJECTIVE
To study an early comprehensive prevention and treatment of sepsis in severely burned patients with delayed fluid resuscitation.


METHODS
From January 1990 to December 2001, 72 cases of patients with delayed fluid resuscitation were admitted to our burn department. Two different periods were divided and analyzed retrospectively. The first period was from January 1990 to December 2001 and the span of the second period was from January 1995 to December 2001.


RESULTS
(1)The mortality rate and incidence of sepsis in the second period (6.5 percent and 17.4 percent) were significantly lower than those of the first period (23.0 percent and 57.7 percent, P<0.05 and P<0.01). (2)The time of wound healing in the second period was (1.9+/-0.9) hours, it was lower than that of the first period (6.6+/-2.5) hours. (3)The serum contents of tumor necrosis factor (TNF) and blood lactic acid (BLA) were increased at all times in two periods and were markedly increased in the first period (all P<0.01).


CONCLUSIONS
Our data demonstrated that measures adopted in the second period for patients with delayed fluid resuscitation, including early excision, early rapid adequate resuscitation, early enteral feeding, increased immunity function, early applying antibactials, xenotransfusion of ultraviolet-irradiated blood, application of recombinant human-growth factor (rh-GH), epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), are beneficial to the prevention and treatment of sepsis in severely burned patients with delayed fluid resuscitation.
Wu
Zu-huang
ZH
Department of Burn and Plastic Surgery, The 95 th Hospital of PLA, Putian 351100, Fujian, China.
Liu
Min
M
Xia
Zhao-fan
ZF
Zhan
Xin-hua
XH
Liu
Shi-kang
SK
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002056:Burns / Q000150:complications / Q000473:pathology / Q000628:therapy*; D004815:Epidermal Growth Factor / Q000097:blood / Q000627:therapeutic use; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000627:therapeutic use; D005346:Fibroblast Growth Factors / Q000097:blood; D005440:Fluid Therapy; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008875:Middle Aged; D044623:Nutrition Therapy; D011379:Prognosis; D018805:Sepsis / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D013997:Time Factors; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D000900:Anti-Bacterial Agents; D014409:Tumor Necrosis Factor-alpha; D016222:Fibroblast Growth Factor 2; D019382:Human Growth Hormone; D019344:Lactic Acid; D005346:Fibroblast Growth Factors; D004815:Epidermal Growth Factor