Long-term persistance of the pathophysiologic response to severe burn injury.
Long-term persistance of the pathophysiologic response to severe burn injury.
复制标题
DOI：
10.1371/journal.pone.0021245
复制
发表时间：
2011
期刊：
影响因子：
3.7
通讯作者：
Herndon DN
中科院分区：
文献类型：
--
作者：
Jeschke MG;Gauglitz GG;Kulp GA;Finnerty CC;Williams FN;Kraft R;Suman OE;Mlcak RP;Herndon DN
严重烧伤儿科患者不良后果的主要原因是初始损伤引起的深刻而复杂的代谢变化。目前尚不清楚这些情况在受伤后急性期后会持续多久。本研究的目的是检查各种临床参数异常的持续性，这些参数通常用于评估严重烧伤儿童在烧伤后长达三年的代谢亢进和炎症改变的程度，以确定患者的具体治疗需求和干预措施。患者：1998 年至 2008 年间入住我们机构的 977 名全身烧伤面积超过 30% 的严重烧伤儿童患者参与了这项研究，并与一组未烧伤、未受伤的儿童进行了比较。在入院时以及烧伤后长达 36 个月的定期间隔内测定人口统计学和临床结果、代谢亢进、身体成分、器官功能、炎症和急性期反应。使用单因素方差分析（Student's t 检验）进行统计分析，并在适当的情况下进行 Bonferroni 校正，显着性在 p<0.05 时接受。静息能量消耗、身体成分、代谢标志物、心脏和器官功能清楚地表明，烧伤在烧伤后长达三年的时间里引起了深刻的变化，表现出明显且长期的代谢亢进，p<0.05。随着代谢亢进的增加，皮质醇、儿茶酚胺、细胞因子和急性期蛋白的显着升高表明烧伤患者在烧伤后长达三年内处于高炎症状态p<0.05。严重烧伤会导致比之前显示的更严重、更持久的代谢亢进和高炎症反应。鉴于与代谢亢进和高炎症反应相关的巨大不良事件，我们现在确定了严重烧伤患者需要更长时间的治疗需求。
Main contributors to adverse outcomes in severely burned pediatric patients are profound and complex metabolic changes in response to the initial injury. It is currently unknown how long these conditions persist beyond the acute phase post-injury. The aim of the present study was to examine the persistence of abnormalities of various clinical parameters commonly utilized to assess the degree hypermetabolic and inflammatory alterations in severely burned children for up to three years post-burn to identify patient specific therapeutic needs and interventions. Patients: Nine-hundred seventy-seven severely burned pediatric patients with burns over 30% of the total body surface admitted to our institution between 1998 and 2008 were enrolled in this study and compared to a cohort non-burned, non-injured children. Demographics and clinical outcomes, hypermetabolism, body composition, organ function, inflammatory and acute phase responses were determined at admission and subsequent regular intervals for up to 36 months post-burn. Statistical analysis was performed using One-way ANOVA, Student's t-test with Bonferroni correction where appropriate with significance accepted at p<0.05. Resting energy expenditure, body composition, metabolic markers, cardiac and organ function clearly demonstrated that burn caused profound alterations for up to three years post-burn demonstrating marked and prolonged hypermetabolism, p<0.05. Along with increased hypermetabolism, significant elevation of cortisol, catecholamines, cytokines, and acute phase proteins indicate that burn patients are in a hyperinflammatory state for up to three years post-burn p<0.05. Severe burn injury leads to a much more profound and prolonged hypermetabolic and hyperinflammatory response than previously shown. Given the tremendous adverse events associated with the hypermetabolic and hyperinflamamtory responses, we now identified treatment needs for severely burned patients for a much more prolonged time.
登录
查看更多内容
影响因子：
3.1
作者：
Fan, J;Li, YH;Lang, CH
通讯作者：
Lang, CH
DOI：
10.1152/ajpendo.1999.276.5.e849
发表时间：
1999-05-01
影响因子：
5.1
作者：
Del Aguila, LF;Claffey, KP;Kirwan, JP
通讯作者：
Kirwan, JP
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
影响因子：
7.1
作者：
HAMILL, PVV;DRIZD, TA;MOORE, WM
通讯作者：
MOORE, WM