Risk factors and outcome of Hypernatremia amongst severe adult burn patients.

Annals of burns and fire disasters Pub Date : 2018-12-31
N N Lam, N T N Minh
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Abstract

A descriptive study was conducted on 135 adult severe burn patients treated at the Burn ICU, National Institute of Burns from 1/2017 to 12/2017. Hypernatremia was defined as increased plasma sodium ≥ 146 mmol/l. It was recorded in 24.4% of total patients with onset time of 8.3 ± 4.8 days, ranging from the 5th to 21st day postburn. Moderate and severe hypernatremia was recorded in 16 (54.5%) patients. Multivariate logistic analysis indicated that increased age, burn extent, mechanical ventilation and ventilation duration were independent predictive factors for the development of hypernatremia. Significantly higher mortality rate (59.5% vs. 40.5% respectively; p = .001) and longer duration of stay in the ICU (23.2 ± 15.4 days vs. 16.2 ± 11.6; p = .01) and in the hospital (74.4 ± 43.7 days vs. 37.9 ± 22.9; p = .002) were seen in the hypernatremia group compared to normonatremic patients. It is necessary to find further effective interventions for the prevention and treatment of this fatal complication among severe burn patients.

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成人重度烧伤患者高钠血症的危险因素和转归。
2017年1月至2017年12月,对135名在美国国家烧伤研究所烧伤重症监护室接受治疗的成人重度烧伤患者进行了描述性研究。高钠血症定义为血浆钠升高≥146 mmol/l。24.4%的患者出现这种情况,发病时间为8.3±4.8天,从烧伤后第5天到第21天不等。16例(54.5%)患者出现中度和重度高钠血症。多因素logistic分析表明,年龄、烧伤程度、机械通气和通气时间的增加是高钠血症发生的独立预测因素。与正常钠血症患者相比,高钠血症组的死亡率明显更高(分别为59.5%和40.5%;p=0.001),在ICU的住院时间更长(23.2±15.4天和16.2±11.6天;p=0.01),在医院的住院时间较长(74.4±43.7天和37.9±22.9天;p=0.002)。有必要找到进一步有效的干预措施来预防和治疗严重烧伤患者的这种致命并发症。
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