Relation between Serum Pro-Brain Natriuretic Peptide, Myoglobin, CK Levels and Morbidity and Mortality in High Voltage Electrical Injuries

Orak, Murat; Üstündağ, Mehmet; Güloğlu, Cahfer; Gökhan, Şervan; Alyan, Ömer

doi:10.2169/internalmedicine.49.3454

Cited by 10 publications

(6 citation statements)

References 16 publications

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“…We performed ECG in all patients exposed to electrical injury but cardiac monitoring was performed only in patients who were symptomatic or who had been exposed to high voltage. The electrical current affects deep tissue, causes increased CPK and CK‐MB, indicating tissue damage . In the present study, patients exposed to high‐voltage electricity had significantly higher CPK, CK‐MB, AST, and ALT compared with low‐voltage exposure.…”

Section: Discussionsupporting

confidence: 49%

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Pediatric electrical injury in Turkey: Five year retrospective hospital‐based study

Özdel

Çakıcı

Şaylı

2019

Pediatrics International

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Background We aimed to evaluate children who presented with electrical injury to the emergency department. We tried to reveal the complications of these patients and the measures to be taken in this regard. Methods Medical records of pediatric patients who were admitted with electrical injury to emergency department between January 2007 and January 2012 were retrospectively reviewed. An information form was completed about demographic data, clinical features, exposure place, electrical current type, clinical course, duration of hospitalization, electrocardiography, echocardiography and other systems findings. Results Children who were the most exposed to electrical injury were children 4 years and under. While low‐voltage current exposure was more common in younger ages, high‐voltage current exposure was more common in older ages. Most of our patients (%72) were exposed to low voltage. Patients who exposed to high‐voltage electricity had significantly higher levels of CPK, CK‐MB, LDH, AST, and ALT compared to patients who were exposed to low voltage electricity. None of the patients have died. Conclusion Young children are often exposed to electric shock at home. Increasing precautions to be taken at home reduces electrical shock injuries. Children and especially families should be educated in this regard.

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Section: Discussionsupporting

confidence: 49%

“…The electrical current affects deep tissue, causes increased CPK and CK-MB, indicating tissue damage. 19,20 In the present study, patients exposed to high-voltage electricity had significantly higher CPK, CK-MB, AST, and ALT compared with low-voltage exposure.…”

Section: Discussionsupporting

confidence: 46%

Pediatric electrical injury in Turkey: Five year retrospective hospital‐based study

Özdel

Çakıcı

Şaylı

2019

Pediatrics International

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“…Moreover, other studies found that left ventricular dysfunction and cardiac injury were uncommon and not associated with serum troponin and CK in patients after HVI [ 12 , 13 ]. A new marker of cardiac injury after electrical injury might be brain natriuretic peptide (BNP), whereas prospective studies regarding the diagnostic accuracy and independence of confounding factors are currently not available [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Electrical injury – a dual center analysis of patient characteristics, therapeutic specifics and outcome predictors

Gille

Schmidt

Dragu

et al. 2018

Scand J Trauma Resusc Emerg Med

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BackgroundElectrical injuries represent life-threatening emergencies. Evidence on differences between high (HVI) and low voltage injuries (LVI) regarding characteristics at presentation, rhabdomyolysis markers, surgical and intensive burn care and outcomes is scarce.MethodsConsecutive patients admitted to two burn centers for electrical injuries over an 18-year period (1998–2015) were evaluated. Analysis included comparisons of HVI vs. LVI regarding demographic data, diagnostic and treatment specific variables, particularly serum creatinine kinase (CK) and myoglobin levels over the course of 4 post injury days (PID), and outcomes.ResultsOf 4075 patients, 162 patients (3.9%) with electrical injury were analyzed. A total of 82 patients (50.6%) were observed with HVI. These patients were younger, had considerably higher morbidity and mortality, and required more extensive burn surgery and more complex burn intensive care than patients with LVI. Admission CK and myoglobin levels correlated significantly with HVI, burn size, ventilator days, surgical interventions, amputation, flap surgery, renal replacement therapy, sepsis, and mortality. The highest serum levels were observed at PID 1 (myoglobin) and PID 2 (CK). In 23 patients (14.2%), cardiac arrhythmias were observed; only 4 of these arrhythmias occurred after hospital admission. The independent predictors of mortality were ventilator days (OR 1.27, 95% CI 1.06–1.51, p = 0.009), number of surgical interventions (OR 0.47, 95% CI 0.27–0.834, p = 0.010) and limb amputations (OR 14.26, 95% CI 1.26–162.1, p = 0.032).ConclusionsPatients with electrical injuries, HVI in particular, are at high risk for severe complications. Due to the need for highly specialized surgery and intensive care, treatment should be reserved to burn units. Serum myoglobin and CK levels reflect the severity of injury and may predict a more complex clinical course. Routine cardiac monitoring > 24 h post injury does not seem to be necessary.

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“…Yine Orak ve ark. elektrik giriş noktasının %60 civarında üst ekstremiteler, çıkış noktasının da benzer oranda alt ekstremiteler olduğunu belirtmişlerdir (12) . Çalışmamızda gövdede yanık alanı olan hastalarda mortalite %19.6' ya çıkmaktadır.…”

Section: İstatistiksel İncelemelerunclassified

Elektri̇k Yaniklarinda Mortali̇teyi̇ Etki̇leyen Faktörler

Üzün¹,

Bombacı²,

Çevik³

2018

bogazicitip

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Elektrotravmalar vücudun anatomik histolojik yapısını ve biokimyasını etkiler ve çok kompleks reaksiyonları tetikler. Bu çalışmanın amacı üçüncü basamak yanık yoğun bakım ünitesinde izlenen elektrik yanık yaralanmalı hastaların mortalite oranlarını etkileyen faktörleri incelemektir. Yöntem ve Gereçler: Bu çalışmada 115 elektrik yanığı olgusunun verileri hastane veri tabanı ve yanık yoğun bakım ünitesi hasta kayıtlarından retrospektif olarak incelendi. Yaş, cinsiyet, voltaj seviyesi,yanıktan etkilenen vücut yüzey alanı, yandıktan sonra hastaneye varış süresi, ek travma ya da cerrahi girişim varlığı, yanık yoğun bakım ünitesinde kalış süresi, mekanik ventilasyon ve renal replasman tedavisi gereksinimleri kaydedildi. Bulgular: Hastaların çoğunluğu (%95) 15-40 yaş aralığında erkekti. Mortalite hızı yüksek voltaj yaralanmalarında düşük voltaj yaralanmalarından anlamlı olarak yüksekti(%13' e karşı %8). Etkilenen vücut yüzey alanı istatistiksel olarak anlamlı mortalite belirteci idi. Vücut yüzey alanı %50'den fazla etkilenen hastalarda mortalite %54.5'e yükselmişti.En fazla etkilenen vücut bölgesi üst ekstremiteler ikenen yüksek mortalite gövde yanığı olan hastalarda idi.Hastaneye ulaşma süresi 24 saatten uzun olan grupta mortalite hastaneye ulaşma süresi 12-24 saat arası ve 12 saatten kısa olan diğer iki gruba göre daha yüksekti (p>0.05). Mekanik ventilasyon, renal replasman tedavisi alanlarda ve yoğun bakım ünitesinde altı günden daha fazla kalan hastalarda mortalite anlamlı oarak daha yüksekti. Yapılan korelasyon analizine göre mortalite ile; yanık şekli, yanık genişliği, APACHE II skor değeri, fasyatomi uygulanması ve genel vücut travması arasında doğru orantılı, cinsiyet ve GKS değeri ile ters orantılı korelasyon tespit edildi. Sonuç: Elektriksel bir yanıktan kaynaklanan hasarın boyutu, cildin alttaki büyük yaralanmayı gizlemesi nedeniyle olaydan sonra bir kaç gün içinde ortaya çıkabilir (Buzdağı etkisi). Elektrik yanıklarına genel vücut travması ve kafa travması eşlik edebilir. Hastanın komada olması, yanık şekli, yanık genişliği, sepsis gelişmesi en önemli mortalite nedenleridir. Bu hastalar dikkatle değerlendirilmeli, multidisipliner yaklaşımla derhal ve etkili müdahale edilmelidir. Olay anından itibaren yeterli ve devamlı sıvı resüsitasyonu yapılmalı, erken dönemde kompartman sendromunun da tedavi edilebileceği bir merkeze ulaştırılmalıdır. Ölümcül ritm bozuklukları gözden kaçmamalıdır.

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Relation between Serum Pro-Brain Natriuretic Peptide, Myoglobin, CK Levels and Morbidity and Mortality in High Voltage Electrical Injuries

Cited by 10 publications

References 16 publications

Pediatric electrical injury in Turkey: Five year retrospective hospital‐based study

Pediatric electrical injury in Turkey: Five year retrospective hospital‐based study

Electrical injury – a dual center analysis of patient characteristics, therapeutic specifics and outcome predictors

Elektri̇k Yaniklarinda Mortali̇teyi̇ Etki̇leyen Faktörler

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