• Title/Summary/Keyword: Burn patients

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Delta Neutrophil Index as an Early Marker of Sepsis in Burn Patients (화상환자에서 패혈증의 조기 예측인자로서의 DNI)

  • Kim, Chong Myung;Ha, Chul Min
    • Journal of the Korean Burn Society
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    • v.22 no.2
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    • pp.38-44
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    • 2019
  • Purpose: The immature granulocyte count has been reported to be a marker of infection and sepsis. The difference in leukocyte subfractions (delta neutrophil index, DNI) in ADVIA 2120 reflects the fraction of circulating immature granulocytes in the blood. This study evaluated the clinical utility of DNI as a severity and prediction marker in critically ill patients with burn sepsis. Methods: One hundred and sixty nine patients admitted to the burn care unit were studied. DNI (the difference in leukocyte subfractions identified by myeloperoxidase and nuclear lobularity channels) was determined using a specific blood cell analyzer. Results: Seventy one patients (42 %) were diagnosed with burn sepsis. DNI was significantly higher in patients with burn sepsis than in patients without (P<0.01). Delta neutrophil index was a better indicator of burn sepsis than C-reactive protein, lactate, white blood cell count, HCO3, base excess, lactate, procalcitonin (odds ratio, 6.31; confidence interval 2.36~16.90; P<0.01). And the receiver operating characteristic curves showed that delta neutrophil index, AUC 0.795 (95% confidence interval, 0.721~0.869; P<0.05) was a better predictor of burn sepsis than lactate, procalcitonin, white blood cell, base excess and abbreviated burn severity index. Conclusion: Delta neutrophil index may be used as a early marker of patients with burn sepsis.

Influencing Predictors of Quality of Life in Burn Patients (화상 환자의 삶의 질 영향 요인)

  • Park, Hyomi;Yoon, young Mi
    • Korean Journal of Adult Nursing
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    • v.17 no.1
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    • pp.100-108
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    • 2005
  • Purpose: The purpose of this study was to identify predictors of quality of life in burn patients. The predictors of quality of life were the subject's characteristics(marriage, income, burn size, burn site, pain and functional limitation) and personal resources(self esteem and social support). Method: 96 burn subjects who were hospitalized participated in the study. The data analysed was with descriptive analysis, ANOVA, Pearson correlation coefficient and multiple regression. Result: Burn patients who had a spouse and had higher levels of income, with smaller size of burn, no arm burn, with lower levels of pain and functional limitation, plus higher levels of self esteem and social support reported higher levels of quality of life(R2=0.5229). Conclusion: Based on the finding of this study, development of nursing intervention programs including reduction of pain and functional limitation, enhancing self esteem and social support can be suggested.

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The Effects of Self-Selected Music on Anxiety and Pain during Burn Dressing Changes (선호 음악요법이 화상환자의 드레싱 시 상태불안과 통증에 미치는 효과)

  • Son, Jung-Tae;Kim, Sun-Hwa
    • Journal of Korean Academy of Nursing
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    • v.36 no.1
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    • pp.159-168
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    • 2006
  • Purpose: The purpose of this study was to examine the effects of music therapy on state anxiety and pain among patients undergoing burn dressing changes. Method: A convenience sample of 32 adult burn patients who were eligible and provided consent were included in the study which was a quasi-experimental study of a nonequivalent control group pretest-posttest design. Fifteen patients in the control group received the routine burn dressing changes but 17 patients in the experimental group listened to self-selected music through headphones connected to a CD player during burn dressing changes for three days. All subjects of the music group chose the type of music that would relax them. Before and after burn dressing changes, subjects completed the State Anxiety Inventory and self-report of pain scores. Result: There was a significant reduction in state anxiety before and after burn dressing changes in those who received music therapy in contrast to those who did not receive music therapy. The music group reported lower pain scores before and after burn dressing changes than did the non-music group. Conclusion: These findings indicate that music therapy composed of self-selected music is a valuable intervention for the treatment of pain and anxiety in patients undergoing burn dressing changes.

The Clinical Investigation Study of Pancreatitis Developed in Burn Patients (화상환자에서 발생한 췌장염의 임상적 고찰)

  • Cho, Gi Yuon;Chun, Jin Woo;Kim, Young Min;Yoon, Jae Chul;Yim, Haejun;Cho, Yong Suk;Kim, Dohern;Hur, Jun;Chun, Wook
    • Journal of the Korean Burn Society
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    • v.22 no.1
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    • pp.10-14
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    • 2019
  • Purpose: To find progression and prognosis of pancreatitis developed in massive burn patients through retrospective analysis. Methods: A retrospective study was conducted on 32 patients with abnormal increase of serum lipase level among 2523 acute burn patients admitted to our burn center from January 1, 2017 to June 30, 2018. Pancreatitis in this study was defined as a serum lipase concentration level that is higher than 180 IU/L which is three times more than the normal level (less than 60 IU/L). In this study, a retrospective analysis was performed on patients with serum lipase level higher than 300 IU/L to better understand causality of burns and pancreatitis. Results: 32 patients (1.27%) had serum lipase level higher than 180 IU/L among 2523 acute burn subjects. And 13 patients (0.52%) of these 32 patients had serum lipase level elevated more than 300 IU/L. The study indicated serum lipase level was increased around 7 days after the injury. It returned to normal level early as after 1 to 2 weeks and late as after 4 to 6 weeks of injury. The serum amylase level was increased as similar modality as to the serum lipase level increase. The serum bilirubin, AST, ALT, LD, and GGT were also observed to be elevated when serum lipase was more than 1000 IU/L. Conclusion: The pancreatitis developed in burn patients are mostly as mild symptom. It could due to the ischemic injury and can easily be treated by a temporary fasting, TPN, and Gabexate intravenous injection.

Procalcitonin as a Predictor of Mortality in Burn Patients with Suspected Sepsis (패혈증이 의심되는 화상환자에서 Procalcitonin이 사망률 예측인자로서의 역할)

  • Kim, In;Kym, Dohern
    • Journal of the Korean Burn Society
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    • v.23 no.2
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    • pp.37-41
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    • 2020
  • Purpose: The purpose of this study was to investigate the usefulness of Procalcitonin (PCT) as a predictor of mortality in patients with burn sepsis, which is closely related to mortality. Methods: A retrospective study was conducted on 912 PCT patients diagnosed with burn sepsis in patients who survived fluid resuscitation for at least 3 days, aged 18 years or older who were admitted to Burn Intensive Care Unit (BICU) of Hallym University Hangang Sacred Heart Hospital from January 2008 to December 2018. Results: Compared with the surviving group, TBSA (31%:65%), Inhalation (59.66%:74.23%) and ABSI (8 points:12 points) were statistically significantly higher in the death group. Looking at the changes in PCT levels in each survival and death group from Week 1 to Week 4, there was a statistically significant difference in PCT levels in the survival and death groups each week (P<0.001). Although there were statistical differences between the survival and death groups in each state (P<0.001), there was no difference in PCT values for each state in both groups (P=0.090). Conclusion: In burn patients suspected of sepsis, the use of PCT is useful for predicting survival and death. It is necessary to conduct research based on prospective study through systematization of measurement standards and data from multiple institutions to increase the utilization of PCT through research that complements the limitations.

Clinical and Statistical Analysis with Age in Cases of Pediatric Burn Patients (소아 화상 환자 2,795례에 대한 연령별 임상 통계학적 분석)

  • Cho, Ki-Hyun;Jang, Young-Chul;Lee, Jong-Wook;Koh, Jang-Hyu;Seo, Dong-Kook;Choi, Jai-Ku
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.445-450
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    • 2011
  • Purpose: The objective of this study is to analyze the epidemiological characteristics of pediatric burn patients and to determine the targets for a pediatric burn prevention program. Methods: A retrospective review of all medical records of acute pediatric burn patients (age < 15 years old) admitted to our hospital between January 2005 and December 2009 was performed. Results: 1472 males and 1323 females were investigated, with a male to female ratio of 1.11 : 1. The greatest number of burn patients were those with an age of 1~2 years (1,463, 52.3%). Scalding burn was the most common cause of injury, which accounted for 2183 (78.1%) patients, followed by contact burns (10.5%), flame burn (4.9%), steam burn (3.6%). Especially steam burn was the second cause of injury in the age under 1 year, while flame burn was the second cause of injury in the age over 7 years. During recent 5 years, incidence of flame burn, steam burn, electrical burn gradually decreased. Variation of seasonal incidence is minimal and most of the patients (2,716 cases, 97.2%) had burns less than 20% TBSA (Total body surface area). The median hospital stay was 18.79 days, and the rate of operation was 28.6% with a high rate in electrical burn (76.2%), flame burn (50.0%), steam burn (46.1%). 6 patients died in this series, which yielded a mortality rate of 0.2%. Conclusion: Prevention efforts should reflect recent study results. Focused prevention program and campaign to make people aware of risk factors and their avoidance is required to reduce the number of burn accidents in children.

Plasma Lactate Clearance as Early Predictors of Morbidity in Major Burn Patients (중증 화상 환자 예후 예측의 조기인자로서 젖산 제거율의 유용성)

  • Lee, Seunghyun;Lee, Hyungjoo;Yoo, Kyungtak
    • Journal of the Korean Burn Society
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    • v.22 no.2
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    • pp.25-29
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    • 2019
  • Purpose: This study was performed to investigate the effect of plasma lactate clearance as predictive factor of major burn patients. Methods: A retrospective review was performed on 119 patients from January 2014 to December 2018, who were admitted as severe burn patients to ICU unit. Plasma lactate was measured upon admission to the hospital and 24hrs after admission. And, hospital day, ICU day, TBSA (Total Body Surface Area) and numbers of surgical intervention were collected after admission. Results: Higher lactate clearance showed negative statistical correlation with survival, hospital day, ICU day & number of surgical interventions. Conclusion: In this study, 24hr lactate clearance might be used as predictor of clinical prognosis following major burn injury.

Serum Lactate, Creatinine and Urine Output: Early Predictors of Mortality after Initial Fluid Resuscitation in Severe Burn Patients (중증 화상에서 초기 수액치료 이후 소변량, 혈중젖산, 크레아티닌 수치 변화와 이에 따른 사망률 예측)

  • Oh, Seyeol;Kym, Dohern
    • Journal of the Korean Burn Society
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    • v.23 no.1
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    • pp.1-6
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    • 2020
  • Purpose: PL, creatinine and urine output are biomarkers of the suitability and prognosis of fluid therapy in severe burn patients. The purpose of this study is to evaluate the usefulness of predicting mortality by biomarkers and its change during initial fluid therapy for severe burn patients. Methods: A retrograde review was performed on 733 patients from January 2014 to December 2018 who were admitted as severe burn patients to our burn intensive care unit (BICU). Plasma lactate, serum creatinine and urine output were measured at the time of admission to the BICU and after 48 hours. ABSI score, Hangang score, APACHEII, revised Baux index and TBSA were collected after admission. Results: 733 patients were enrolled. PL was the most useful indicators for predicting mortality in burn patients at the time of admission (AUC: 0.813) and after 48 hours (AUC: 0.698). On the other hand, mortality prediction from initial fluid therapy for 48 hours showed different results. Only creatinine showed statistical differences (P<0.05) in mortality prediction. But there were no statistical differences in mortality prediction with PL and UO (P>0.05). Conclusion: In this study, PL was most useful predictor among biomarkers for predicting mortality. Improvement in creatinine levels during the first 48 hours is associated with improved mortality. Therefore, efforts are needed to improve creatinine levels.

Stress and Burn-Out Experience in Caregivers of Patients with Senile Dementia (치매환자 부양자의 스트레스와 소진경험)

  • Son, Gye-Soon
    • Journal of Korean Academy of Rural Health Nursing
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    • v.1 no.1
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    • pp.40-48
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    • 2006
  • Purpose: This study was done to identify the experience of stress and burn-out in caregivers of patients with senile dementia. Method: To evaluate the degree of stress and burn-out in caregivers of patients with senile dementia, 64 caregivers and matched to 64 patients with senile dementia at a Primary Health Care Post in South Kyung Sung Province were selected. The study was carried out from March 6 to March 30, 2001. Data on the degree of dementia in the patients was measured by the MMSE-K (Mini-Mental State Examination-Korea) and caregiver characteristics such as, sex, age, marital status, educational level, job, socioeconomic status, religion, number in family, relationship with patient, duration of care, and chronic disease in caregiver were collected by direct interview with a questionnaire. Results: Of 64 patients with senile dementia, 15.6% were classified as mild dementia (MMSE score 20-24) and 84.4%, as severe dementia. There were no significant characteristics of caregivers associated with the degree of stress and burn-out experience. The degree of burn-out in these caregivers of patients with severe dementia (mean value 94.3) was significantly higher than the 81.4 for those caring for patients with mild dementia (p<0.05). However, the degree of stress was not significantly related with the degree of dementia. The proportion experiencing severe burn-out (above score 4) was 54.7% in the physical domain, 90.6% in the emotional domain, and 73.4% in psychiatric domain, respectively. Conclusion: The above findings suggest that the degree of stress and burn-out experienced by caregivers of patients with senile dementia are high. Also the degree of burn-out experienced by in caregivers of patients with severe dementia was higher than for those caring for patients with mild dementia.

Analysis of Exposure Factors for Clinical and Preventive Aspects of Pediatric Electrical Burn Patients who Visited the Emergency Department (응급실에 내원한 소아 전기 화상 환자의 임상적 양상과 예방을 위한 노출 요인 분석)

  • Park, Sang Jun;Kim, Sung Wook;Jeong, Won Jung;Oh, Sang Hoon;Park, Jeong Taek
    • Journal of Trauma and Injury
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    • v.28 no.3
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    • pp.170-176
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    • 2015
  • Purpose: The aims of this study were to discuss treatment and prevention under the age of 18 to identify the characteristics of the electrical burn patients. Methods: We retrospectively reviewed medical records of 97 patients with under age 18 of electric burn who were treated in emergency department of quarterly over 10,000 targets within the desired hospital for evaluation of electrical injuries between January 1, 2009 and December, 2013. We investigated age, gender, injury mechanism, season, degree of burn, surface of burn, complication, blood test, and voltage, kind of current. Results: Of the patients, 50 (50.5%) patients were in the first degree burn and 47 (49.5%) patients were in second degree burn. 68 (70.1%) patients had electric burn at home. 75 (85.2%) of 88 patients had normal sinus rhythm and other 13 people showed a RBBB, VPC, sinus bradycardia, sinus tachycardia. 41 (42.3) of 97 patients were in infants and 26 (26.8%) patients were in adolescence. Conclusion: The results of this study emphasize the need for prevention of electricity at home for childhood and education of the adolescence.

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