Cogswell J J, Chu A C
Arch Dis Child. 1976 Jan;51(1):67-72. doi: 10.1136/adc.51.1.67.
580 children were admitted to the paediatric burns unit of Guy's Hospital between 1964 and 1974, of which 97 had burns exceeding 20% of the surface area, and 33 died (34% mortality). 80% of those with burns exceeding 50% of the surface area died. Young children died after less extensive burns. Respiratory failure, sepsis, and malnutrition were the most lethal complications. The prompt use and careful control of intravenous fluids had reduced the immediate complications associated with shock, and acute renal failure is now uncommon. Respiratory failure resulted in many deaths during the first week after injury. The need for intensive respiratory care involving paediatric, anaesthetic, and surgical staff is stressed. Sepsis and malnutrition remain major threats to survival. Improved methods of bacteriological control by laminar air flow units and topical antibacterial agents may help to reduce infection in the future. Reduction of energy expenditure by temporary skin coverings and a high environmental temperature, combined with a high calorie intake by oral and intravenous routes, may improve the outlook for severly burned children in the next decade.
1964年至1974年间，580名儿童住进了盖伊医院的儿科烧伤病房，其中97名儿童烧伤面积超过体表面积的20%，33名死亡（死亡率为34%）。烧伤面积超过50%的患者中，80%死亡。年龄较小的儿童在烧伤面积较小时也会死亡。呼吸衰竭、败血症和营养不良是最致命的并发症。及时使用并谨慎控制静脉输液减少了与休克相关的即刻并发症，急性肾衰竭现在已不常见。呼吸衰竭在受伤后的第一周导致了许多死亡。强调了需要儿科、麻醉和外科工作人员进行强化呼吸护理。败血症和营养不良仍然是生存的主要威胁。通过层流空气净化装置和局部抗菌剂改进细菌控制方法，可能有助于未来减少感染。通过临时皮肤覆盖物和较高的环境温度降低能量消耗，再结合经口和静脉途径摄入高热量，可能会改善未来十年严重烧伤儿童的预后。
