Burn size determines the inflammatory and hypermetabolic response.
Burn size determines the inflammatory and hypermetabolic response.
复制标题
DOI：
10.1186/cc6102
复制
发表时间：
2007
期刊：
影响因子：
15.1
通讯作者：
Herndon, David N.
中科院分区：
文献类型：
--
作者：
Jeschke, Marc G.;Mlcak, Ronald P.;Finnerty, Celeste C.;Norbury, William B.;Gauglitz, Gerd G.;Kulp, Gabriela A.;Herndon, David N.
烧伤面积的增加导致烧伤患者死亡率的增加。死亡是否由于炎症、高代谢或其他病理生理因素尚未完全确定。本研究的目的是通过一项大型前瞻性临床试验来确定不同烧伤大小是否与炎症、身体成分、蛋白质合成或器官功能的差异有关。小儿烧伤患者分为烧伤大小4组：烧伤面积<40% TBSA组、烧伤面积40-59% TBSA组、烧伤面积60-79%组和烧伤面积80% TBSA组。测定了人口统计学和临床数据、高代谢、炎症反应、身体组成、肌肉蛋白质净平衡、血清和尿液激素和蛋白质、心功能和肝脏大小的变化。189例年龄和性别分布相似的儿童患者被纳入研究（TBSA烧伤<40%,n = 43； TBSA烧伤40-59%，n = 79； TBSA烧伤60-79%，n = 46； TBSA烧伤80%，n = 21）。烧伤面积较大的患者手术次数多，感染、败血症发生率高，死亡率高于其他组（P < 0.05）。预测静息能量消耗百分比以> ~ 80% TBSA组最高，其次为60 ~ 79% TBSA组（P < 0.05）。烧伤> ~ 80%患儿体重、瘦体质量、肌肉蛋白和骨矿物质含量下降最多（P < 0.05）。尿皮质醇浓度在80-99%和60-79% TBSA烧伤组最高，心肌抑制显著，肝脏大小变化增加（P < 0.05）。细胞因子谱中IL-8、TNF、IL-6、IL-12p70、单核细胞趋化蛋白-1、粒细胞-巨噬细胞集落刺激因子的表达差异有统计学意义（P < 0.05）。烧伤患者的发病率和死亡率与烧伤大小有关，始于60%的TBSA烧伤，是由于高代谢和炎症反应增加，以及心功能受损。
Increased burn size leads to increased mortality of burned patients. Whether mortality is due to inflammation, hypermetabolism or other pathophysiologic contributing factors is not entirely determined. The purpose of the present study was to determine in a large prospective clinical trial whether different burn sizes are associated with differences in inflammation, body composition, protein synthesis, or organ function. Pediatric burned patients were divided into four burn size groups: <40% total body surface area (TBSA) burn, 40–59% TBSA burn, 60–79% TBSA burn, and >80% TBSA burn. Demographic and clinical data, hypermetabolism, the inflammatory response, body composition, the muscle protein net balance, serum and urine hormones and proteins, and cardiac function and changes in liver size were determined. One hundred and eighty-nine pediatric patients of similar age and gender distribution were included in the study (<40% TBSA burn, n = 43; 40–59% TBSA burn, n = 79; 60–79% TBSA burn, n = 46; >80% TBSA burn, n = 21). Patients with larger burns had more operations, a greater incidence of infections and sepsis, and higher mortality rates compared with the other groups (P < 0.05). The percentage predicted resting energy expenditure was highest in the >80% TBSA group, followed by the 60–79% TBSA burn group (P < 0.05). Children with >80% burns lost the most body weight, lean body mass, muscle protein and bone mineral content (P < 0.05). The urine cortisol concentration was highest in the 80–99% and 60–79% TBSA burn groups, associated with significant myocardial depression and increased change in liver size (P < 0.05). The cytokine profile showed distinct differences in expression of IL-8, TNF, IL-6, IL-12p70, monocyte chemoattractant protein-1 and granulocyte–macrophage colony-stimulating factor (P < 0.05). Morbidity and mortality in burned patients is burn size dependent, starts at a 60% TBSA burn and is due to an increased hypermetabolic and inflammatory reaction, along with impaired cardiac function.
登录
查看更多内容
影响因子：
3.9
作者：
Demling, RH;DeSanti, L
通讯作者：
DeSanti, L
影响因子：
9
作者：
Hart, DW;Wolf, SE;Herndon, DN
通讯作者：
Herndon, DN
影响因子：
9
作者：
Herndon, DN;Ramzy, PI;Wolf, SE
通讯作者：
Wolf, SE
DOI：
10.1006/bbrc.1998.8089
发表时间：
1998-02-04
影响因子：
3.1
作者：
Delhanty, PJD
通讯作者：
Delhanty, PJD
DOI：
10.1152/ajpendo.1997.273.1.e122
发表时间：
1997-07-01
影响因子：
5.1
作者：
Biolo, G;Tipton, KD;Wolfe, RR
通讯作者：
Wolfe, RR