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入住儿科重症监护病房的烧伤儿童的特征与转归

Characteristics and outcome of burned children admitted to a pediatric intensive care unit.

作者信息

Barcellos Luciana Gil, Silva Ana Paula Pereira da, Piva Jefferson Pedro, Rech Leandra, Brondani Tamires Goulart

机构信息

Unidade de Terapia Intensiva de Trauma Pediátrico, Hospital Municipal de Pronto Socorro de Porto Alegre - Porto Alegre (RS), Brasil.

Unidade de Tratamento Intensivo Pediátrico, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil.

出版信息

Rev Bras Ter Intensiva. 2018 Jul-Sept;30(3):333-337. doi: 10.5935/0103-507x.20180045. Epub 2018 Oct 4.

Abstract

OBJECTIVE

To analyze the characteristics and outcomes of children hospitalized for burns in a pediatric trauma intensive care unit for burn patients.

METHODS

An observational study was conducted through the retrospective analysis of children (< 16 years) admitted to the pediatric trauma intensive care unit for burn victims between January 2013 and December 2015. Sociodemographic and clinical variables were analyzed including the causal agent, burned body surface, presence of inhalation injury, length of hospital stay and mortality.

RESULTS

The study analyzed a sum of 140 patients; 61.8% were male, with a median age of 24 months and an overall mortality of 5%. The main cause of burns was scalding (51.4%), followed by accidents involving fire (38.6%) and electric shock (6.4%). Mechanical ventilation was used in 20.7% of the cases. Associated inhalation injury presented a relative risk of 6.1 (3.5 - 10.7) of needing ventilatory support and a relative risk of mortality of 14.1 (2.9 - 68.3) compared to patients without this associated injury. A significant connection was found between burned body surface and mortality (p < 0.002), reaching 80% in patients with a burned area greater than 50%. Patients who died had a significantly higher Tobiasen Abbreviated Burn Severity Index than survivors (9.6 ± 2.2 versus 4.4 ± 1.1; p < 0.001). A Tobiasen Abbreviated Burn Severity Index ≥ 7 represented a relative risk of death of 68.4 (95%CI 9.1 - 513.5).

CONCLUSION

Scalding burns are quite frequent and are associated with high morbidity. Mortality is associated with the amount of burned body surface and the presence of inhalation injury. Special emphasis should be given to accidents involving fire, reinforcing proper diagnosis and treatment of inhalation injury.

摘要

目的

分析在小儿烧伤重症监护病房住院的烧伤患儿的特征及治疗结果。

方法

通过回顾性分析2013年1月至2015年12月期间入住小儿烧伤重症监护病房的16岁以下儿童进行观察性研究。分析社会人口统计学和临床变量,包括致伤因素、烧伤体表面积、吸入性损伤的存在、住院时间和死亡率。

结果

该研究共分析了140例患者;61.8%为男性,中位年龄为24个月,总死亡率为5%。烧伤的主要原因是烫伤(51.4%),其次是火灾事故(38.6%)和电击伤(6.4%)。20.7%的病例使用了机械通气。与无吸入性损伤的患者相比,合并吸入性损伤者需要通气支持的相对风险为6.1(3.5 - 10.7),死亡相对风险为14.1(2.9 - 68.3)。烧伤体表面积与死亡率之间存在显著关联(p < 0.002),烧伤面积大于50%的患者死亡率达到80%。死亡患者的托比亚森简化烧伤严重程度指数显著高于幸存者(9.6 ± 2.2对4.4 ± 1.1;p < 0.001)。托比亚森简化烧伤严重程度指数≥7表示死亡相对风险为68.4(95%CI 9.1 - 513.5)。

结论

烫伤很常见,且发病率高。死亡率与烧伤体表面积和吸入性损伤的存在有关。应特别重视火灾事故,加强对吸入性损伤的正确诊断和治疗。

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