Clinico-pathological profile and outcome of inhalational burns.
OBJECTIVE
To determine clinico-pathological profile and outcome of inhalational burns in a specialized burns treatment unit.


METHODS
Case-series.


METHODS
The Department of Plastic Surgery and Burns Centre Unit, Combined Military Hospital, Kharian Cantonment in March 2005.


METHODS
Patients of inhalational burns were included and evacuated within 30 hours of accident to the specialized burns centre after immediate resuscitation. Total Body Surface Area (TBSA) involved in burns was calculated. Complete blood count and renal profile along with serum albumin and total proteins was obtained. Portable chest radiographs and bronchoscopic examination was conducted. Escarotomies were carried and wounds were covered with split thickness skin grafts. Ventilatory support was used as needed. Comparison of the clinico-pathological profile of surviving and fatal cases was done for significance using t-test.


RESULTS
There were 19 patients of inhalational burns, 8 (42%) of whom expired. The mean percentage of TBSA in 11 surviving patients was 50+/-10.87 and 70+/-15.46 in fatal cases. The mean haemoglobin (Hb) on admission was 15.8+/-1.6 g/dL and after fluid resuscitation it became 11.4+/-1.5 g/dL. The mean Total Leucocyte Count (TLC) in surviving patients was 9.6+/-6.1 x 10(9)/L and 1.5+/-2.3 x 10(9)/L in fatal cases (p=0.001). The mean platelet count of surviving patients was 205+/-63 x 10(12)/L while in fatal cases was 58+/-48 x 10(12)/L (p=0.05). The serum urea levels in surviving patients was 4.3+/-2 mmol/L while in fatal cases was 8.6+/-0.9 mmol/L (p=0.05). The serum creatinine levels were 98.2+/-16.5 micromol/L in the survivor group and 249.5+/-76 micromol/L in the mortality group (p=0.05). The serum total protein in surviving patients was 63+/-8 g/dL while in mortality cases it was 57+/-7 g/L. Serum albumin in the survivor group was 36.7+/-5 g/L and 35+/-4 g/L in fatal cases. Significant in Hb, protein and albumin levels. All the expired patients had acute respiratory distress syndrome while acute renal failure with multi-organ failure co-existed in 6 patients.


CONCLUSIONS
Inhalational burns injury cases multi-system injury with high mortality. Body area involvement, total leucocyte count, platelet count, serum area and serum creatinine are important indicators of survival.
Murtaza
Badar
B
Department of General Surgery, Combined Military Hospital, Bahawal Nagar Cantonment. badar_murtaza@yahoo.com
Sharif
Muhammad Ashraf
MA
Tamimy
Muhammad Sarmad
MS
Dar
Muhammad Farooq
MF
Aslam
Aneel
A
Mujtaba Kazmi
Syed Tahawar
ST
Ishaque
Muhammad
M
D000328:Adult; D001798:Blood Proteins / Q000032:analysis; D001830:Body Surface Area; D002059:Burns, Inhalation / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D003404:Creatinine / Q000097:blood; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D010154:Pakistan / Q000453:epidemiology; D010976:Platelet Count; D012709:Serum Albumin / Q000032:analysis; D016896:Treatment Outcome; D014508:Urea / Q000097:blood
D001798:Blood Proteins; D006454:Hemoglobins; D012709:Serum Albumin; D014508:Urea; D003404:Creatinine