대한화상학회지 (Journal of the Korean Burn Society)

대한화상학회 (Korean Burn Society)
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중증 화상에서 초기 수액치료 이후 소변량, 혈중젖산, 크레아티닌 수치 변화와 이에 따른 사망률 예측

Serum Lactate, Creatinine and Urine Output: Early Predictors of Mortality after Initial Fluid Resuscitation in Severe Burn Patients

  • 오세열 (한림대학교 강남성심병원 외과) ;
  • 김도헌 (한림대학교 한강성심병원 화상센터 화상외과)
  • Oh, Seyeol (Department of General Surgery, Kangnam Sacred Heart Hospital, Hallym University Medical Center) ;
  • Kym, Dohern (Department of Surgery and Critical Care, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center)
  • 투고 : 2020.05.09
  • 심사 : 2020.05.19
  • 발행 : 2020.06.30
⟨ 이전 논문 다음 논문 ⟩

초록

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.

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참고문헌

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