系统性去甲肾上腺素对烧伤休克患者切向切除和裂厚皮肤移植结果影响的回顾性分析

Q3 Medicine

Burns open : an international open access journal for burn injuries Pub Date : 2023-07-01 DOI:10.1016/j.burnso.2023.05.001

Albin John , Ilina Terziyski , Annie Snitman , John Garza , Alan Pang , Callie Adams , Grant Sorensen , John Griswold

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引用次数: 0

摘要

目的烧伤休克是一种严重的并发症，表现为严重的心血管抑制，可能需要血管加压剂支持以维持血流动力学稳定。本研究旨在探讨需要切除和植皮的深度烧伤患者全身去甲肾上腺素的使用和植皮的模式。方法回顾性分析2014年1月至2020年6月至区域烧伤中心就诊的年龄18-89岁的烧伤患者，这些患者在入院前48小时内接受了全身血管加压药物治疗，并接受了至少一次切向切除和分厚皮肤移植(STSG)手术，作为其治疗的一部分。接受血管加压药物治疗的患者与未接受血管加压药物治疗的患者进行比较，这些患者具有相似的人口统计学特征，烧伤创伤和烟雾吸入性损伤。调查的主要结果包括:平均总移植量、接受的去甲肾上腺素量、用于复苏的液体总量、手术次数和住院时间。结果接受全身性去甲肾上腺素治疗的患者的平均移植物摄取(80.0%)显著低于未接受全身性去甲肾上腺素治疗的患者(91.4%，p <0.001)。结论烧伤休克患者应以液体复苏为主，并在必要时加用血管加压药物。

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A retrospective analysis of systemic Norepinephrine impact on tangential excision and split thickness skin graft outcomes in burn shock patients

Objective

Burn shock is a serious complication that presents with profound cardiovascular suppression that may require vasopressor support for hemodynamic stability. This study aims to explore the patterns of systemic Norepinephrine use and skin graft take in patients with deep burns requiring excision and grafting.

Methods

Burn patients ages 18–89 years that presented to our regional burn center from January 2014–June 2020 and were treated with systemic vasopressors within the first 48 h of admission, and received at least one tangential excision and split thickness skin graft (STSG) procedure as part of their treatment were retrospectively identified. Patients receiving vasopressors were compared to a matched cohort of patients not receiving vasopressors yet with similar demographics, burn trauma, and smoke inhalation injury. Major outcomes investigated included: average overall graft take, amount of Norepinephrine received, total amount of fluids used for resuscitation, number of operations, and length of hospital stay.

Results

The mean graft uptake for patients treated with systemic Norepinephrine (80.0%) was significantly lower than the mean graft uptake for patients not treated with systemic Norepinephrine (91.4%, p < 0.001).