Renal function and renal failure in badly burned children

Cameron, J. S.; Miller-Jones, C.M.H.

doi:10.1002/bjs.1800540213

Cited by 43 publications

(4 citation statements)

References 24 publications

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“…Late AKI has long been associated with sepsis and MODS (1, 32, 33). Additionally, MODS and late kidney injury have been associated with inhalation injury (1, 7, 33), but our decision tree does not include inhalation injury. Although univariate analysis found significant differences in the percentage of inhalation injury between those with none, early, or late AKI, there were a significant number of patients with inhalation injury among those that did not suffer any AKI or who only experienced early AKI (25% and 44.9%, respectively, Table 2).…”

Section: Discussionmentioning

confidence: 99%

Predicting Acute Kidney Injury Among Burn Patients in the 21st Century

Dobrowolsky

Shakir

Sinacore

et al. 2012

Journal of Burn Care & Research

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Objective Historically, acute kidney injury (AKI) carried a deadly prognosis in the burn population. Our aim with this study was to provide a modern description of AKI in the burn population and to develop a prediction tool for identifying patients at risk for late AKI. Methods A large multi-institution database, the Glue Grant's trauma related database (TRDB), was used to characterize AKI in a cohort of critically ill burn patients. We defined AKI according to the RIFLE criteria and categorized AKI as early, late or progressive. We then used Classification and Regression Tree (CART) analysis to create a decision tree with data obtained from the first 48 hours of admission to predict which subset of patients would develop late AKI. We tested the accuracy of this decision tree in a separate, single-institution cohort of burn patients who met the same criteria for entry into the Glue Grant study Results Of the 220 total patients analyzed from the Glue Grant cohort, 49 (22.2%) developed early AKI, 39 (17.7%) developed late AKI, and 16 (7.2%) developed progressive AKI. The group with progressive AKI was statistically older, with more comorbidities, and with the worst survival when compared to those with early or late AKI. Using CART analysis, we developed a decision tree with an overall accuracy of 80% for the development of late AKI for the Glue Grant dataset. We then tested this decision tree on a smaller dataset from our own institution to validate this tool, and found it to be 73% accurate. Conclusions AKI is common in severe burns with notable differences between early, late, and progressive AKI. Additionally, CART analysis provided a predictive model for early identification of patients at highest risk for developing late AKI with proven clinical accuracy.

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Section: Discussionmentioning

confidence: 99%

Predicting Acute Kidney Injury Among Burn Patients in the 21st Century

Dobrowolsky

Shakir

Sinacore

et al. 2012

Journal of Burn Care & Research

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“…Albumin was withheld until hypoproteinemia was demonstrable, usually the 3rd or 4th day, by which time third space losses (in the skin) had been recovered by the circulation. The importance of altered renal function assessing prognosis in burned children has recently been discussed [3].…”

Section: A Treatment Of Poor Perfusion Due To Extracellular Fluid (Ementioning

confidence: 99%

Management of Acute Renal Failure in Infants and Children

Lieberman¹

1973

Nephron

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The definition, causes and management of acute renal failure in children are described. This includes treatment of both specific and nonspecific problems. The specific problems include hyperkalemia, acidosis, sodium control, hypocalcemia, extracellular volume overload, hypertension, seizures and anemia. Supportive treatment is also considered including continuing assessment of the patient’s status, water and calorie requirements, central venous pressure measurements and transport of patients! The indications for peritoneal dialysis are described and also the technique and possible complications.

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“…Accidental injury cases have shown a marked increase in survival rate during this period, apparently benefiting most from improvements in therapy, while all our patients with renal failure following burns died. This distressing failure with burns is a common experience in all renal units (Cameron & Miller-Jones 1967). The mortality of post-operative patients was about 50 %, a disappointing rate that has not improved over the years.…”

Section: Buckinghamshire)mentioning

confidence: 99%

Some Aspects of Renal Damage following Trauma

Ct¹

1970

Proceedings of the Royal Society of Medicine

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Renal function and renal failure in badly burned children

Cited by 43 publications

References 24 publications

Predicting Acute Kidney Injury Among Burn Patients in the 21st Century

Predicting Acute Kidney Injury Among Burn Patients in the 21st Century

Management of Acute Renal Failure in Infants and Children

Some Aspects of Renal Damage following Trauma

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