Renal Replacement Therapy in Severe Burns: A Multicenter Observational Study.

MedStar author(s):
Citation: Journal of Burn Care & Research. 39(6):1017-1021, 2018 10 23.PMID: 29931223Institution: MedStar Washington Hospital CenterDepartment: Surgery/Burn ServicesForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Acute Kidney Injury/et [Etiology] | *Acute Kidney Injury/th [Therapy] | *Burns/co [Complications] | *Renal Replacement Therapy | Female | Humans | Male | Middle Aged | United StatesYear: 2018Local holdings: Available online through MWHC library: 2006 - present, Available in print through MWHC library: 2006 - presentISSN:
  • 1559-047X
Name of journal: Journal of burn care & research : official publication of the American Burn AssociationAbstract: 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.All authors: Aden JK, Albrecht M, Arnold-Ross AL, Arnoldo BD, Caruso DM, Chung KK, Coates EC, Conrad PF, Friedman B, Hickerson WL, Howard C, Johnson LS, Karlnoski RA, Mann-Salinas EA, McLawhorn MM, Mosier MJ, Randomized controlled Evaluation of high-volume hemofiltration in adult burn patients with Septic shoCk and acUte kidnEy injury (RESCUE) Investigators, Smith DJ Jr, Sprague AM, Wolf SEOriginally published: Journal of Burn Care & Research. 2018 Jun 20Fiscal year: FY2018Digital Object Identifier: Date added to catalog: 2018-07-06
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Journal Article MedStar Authors Catalog Article 29931223 Available 29931223

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.

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