Inhalation Injury Is Associated With Endotheliopathy and Abnormal Fibrinolytic Phenotypes in Burn Patients: A Cohort Study.

Autor:	Keyloun, John W, Le, Tuan D, Brummel-Ziedins, Kathleen E, Mclawhorn, Melissa M, Bravo, Maria C, Orfeo, Thomas, Johnson, Laura S, Moffatt, Lauren T, Pusateri, Anthony E, Shupp, Jeffrey W, Group, SYSCOT Study, SYSCOT Study Group
Předmět:	DISSEMINATED intravascular coagulation EVALUATION of medical care BURN patients ENDOTHELIUM MORTALITY SMOKE inhalation injuries RETROSPECTIVE studies BLOOD collection THROMBELASTOGRAPHY HEALTH outcome assessment MANN Whitney U Test FISHER exact test FIBRINOLYSIS ENZYME-linked immunosorbent assay CHI-squared test DESCRIPTIVE statistics PHENOTYPES LONGITUDINAL method DISEASE risk factors DISEASE complications
Zdroj:	Journal of Burn Care & Research; Mar/Apr2022, Vol. 43 Issue 2, p432-439, 8p
Abstrakt:	Burn injury is associated with endothelial dysfunction and coagulopathy and concomitant inhalation injury (IHI) increases morbidity and mortality. The aim of this work is to identify associations between IHI, coagulation homeostasis, vascular endothelium, and clinical outcomes in burn patients. One hundred and twelve patients presenting to a regional burn center were included in this retrospective cohort study. Whole blood was collected at set intervals from admission through 24 hours and underwent viscoelastic assay with rapid thromboelastography (rTEG). Syndecan-1 (SDC-1) on admission was quantified by ELISA. Patients were grouped by the presence (n = 28) or absence (n = 84) of concomitant IHI and rTEG parameters, fibrinolytic phenotypes, SDC-1, and clinical outcomes were compared. Of the 112 thermally injured patients, 28 (25%) had IHI. Most patients were male (68.8%) with a median age of 40 (interquartile range, 29-57) years. Patients with IHI had higher overall mortality (42.68% vs 8.3%; P < .0001). rTEG LY30 was lower in patients with IHI at hours 4 and 12 (P < .05). There was a pattern of increased abnormal fibrinolytic phenotypes among IHI patients. There was a greater proportion of IHI patients with endotheliopathy (SDC-1 > 34 ng/ml) (64.7% vs 26.4%; P = .008). There was a pattern of increased mortality among patients with IHI and endotheliopathy (0% vs 72.7%; P = .004). Significant differences between patients with and without IHI were found in measures assessing fibrinolytic potential and endotheliopathy. Mortality was associated with abnormal fibrinolysis, endotheliopathy, and IHI. However, the extent to which IHI-associated dysfunction is independent of TBSA burn size remains to be elucidated. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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