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[Prevention and treatment of MODS in severely burned patients: an institute based retrospective study]
1Burn Institute, 304th Hospital, People's Liberation Army, Beijing 100037, China.
Objective:
To determine if the preventive and treatment measures developed from basic and clinical research work have any effects on the incidence and outcome of MODS in severely burned patients.
Methods:
657 extensively burned patients (burn size exceeding 30% TBSA) admitted to the clinical department from January 1970 through October 1999 were studied. The morbidity and mortality rates were compared in patient groups hospitalized before and after January 1990 when major preventive and treatment measures began to be extensively executed. These measures consisted of prompt, rapid and adequate fluid resuscitation, restoration of bowel blood supply with anisodamine (654 - 2), use of oxygen free radical scavengers (e.g. mannitol, vitamin C and E), extensive escharectomy during shock stage, early tube feeding, support of organ function, etc.
Results:
Before 1990 when very few preventive and treatment measures were applied, the incidence of MODS, 17.3% (64 out of 369), and the death rate 87.5% (56 out of 64). After 1990, with the application of various preventive measures and treatment, the morbidity and mortality rates were reduced to 6.9% (20/288) and 40.0% (8/20), respectively.
Conclusion:
Our results suggest that measures which mitigate or eliminate the predisposing and causative factors of MODS may be salutary in the prevention and treatment of MODS after extensive burn injury.
Insights
Implementing advanced preventive and treatment strategies significantly reduced the incidence and mortality of Multiple Organ Dysfunction Syndrome (MODS) in severely burned patients. These findings highlight the effectiveness of targeted interventions in improving patient outcomes following extensive burn injuries.
Area of Science:
- Burn Trauma Research
- Critical Care Medicine
- Sepsis and Inflammation Studies
Context:
- Severely burned patients face high risks of Multiple Organ Dysfunction Syndrome (MODS).
- Traditional treatment protocols showed limited success in mitigating MODS incidence and mortality.
- A shift towards comprehensive preventive and therapeutic strategies was implemented in 1990.
Purpose:
- To evaluate the impact of enhanced preventive and treatment measures on MODS in extensively burned patients.
- To compare MODS morbidity and mortality rates before and after the widespread execution of new protocols.
- To assess the efficacy of interventions aimed at mitigating MODS predisposing factors.
Summary:
- A study of 657 extensively burned patients compared outcomes before and after 1990, when new measures were introduced.
- Key interventions included fluid resuscitation, oxygen free radical scavengers, early nutritional support, and organ function support.
- MODS incidence decreased from 17.3% to 6.9%, and mortality dropped from 87.5% to 40.0% post-1990.
Impact:
- The study demonstrates that proactive measures significantly improve outcomes for severe burn patients.
- Findings support the integration of comprehensive strategies to prevent and treat MODS.
- This research offers valuable insights for critical care protocols in burn management.
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