Renal Replacement Therapy in Severe Burns: A Multicenter Observational Study.
- 2018
Available online through MWHC library: 2006 - present, Available in print through MWHC library: 2006 - present
Acute kidney injury (AKI) after severe burns is historically associated with a high mortality. Over the past two decades, various modes of renal replacement therapy (RRT) have been utilized in this population. The purpose of this multicenter study was to evaluate demographic, treatment and outcomes data among severe burn patients treated with RRT collectively at various burn centers around the United States. After institutional review board approval, a multicenter observational study was conducted. All adult patients 18 or older, admitted with severe burns who were placed on RRT for acute indications but not randomized into a concurrently enrolling interventional trial were included. Across 8 participating burn centers, 171 subjects were enrolled during a 4 year period. Complete data was available in 170 subjects with a mean age of 51+/-17, percent total body surface area (TBSA) burn of 38+/-26% and Injury Severity Score of 27+/-21. 80% of subjects were male and 34% were diagnosed with smoke inhalation injury. The preferred mode of therapy was continuous venovenous hemofiltration at a mean delivered dose of 37+/-19 (mL/kg/hr) and a treatment duration of 13+/-24 days. Overall, in hospital mortality was 50%. Among survivors, 21% required RRT upon discharge from the hospital while 9% continued to require RRT 6 months after discharge. This is the first multi-center cohort of burn patients who underwent RRT reported to date. Overall mortality is comparable to other critically ill populations who undergo RRT. Most patients who survive to discharge eventually recover renal function.
English
1559-047X
10.1093/jbcr/iry036 [doi] 5040630 [pii]
*Acute Kidney Injury/et [Etiology] *Acute Kidney Injury/th [Therapy] *Burns/co [Complications] *Renal Replacement Therapy Female Humans Male Middle Aged United States