Paediatric ICU burns in Finland 1994-2004

The paediatric burn population requiring intensive care in Finland has never been examined before. The aim of this study was firstly to determine the aetiology, incidence and prognosis of paediatric burns requiring intensive care in Finland and secondly to compare the possible differences between the two national burn centres.

All burn patients' charts were retrospectively reviewed in two national burn centres from an 11-year-period. Patients whose ICU stay was more than 48h, were included.

Forty-five children who were hospitalized in the two burn centres during the study period met the inclusion criteria. They represent 2.4% (45/1898) of all burns victims hospitalized in these burn centres during that time giving an incidence of 0.1/100,000 per year in Finland. The median age was 5 years, every third patient was 0-2 years old and 75.6% were male. Most burns were scalds (42.2%), which caused all burns (100%) in age group 0-2 years. Flame burns were most frequent (83%) in the age group 6-10 years. In the 11-16 years old patients, high voltage/electric burns caused 50% of all burns and flame the other 50%. The overall median TBSA in all burns was 26%. The median (range) hospital stay was 12 days (2-193) (0.88 days/% burned) and the median (range) ICU days was 7 (2-64) (0.29 days/%). Intubation and respirator therapy was needed in 31 (46%) patients. There were no patients who needed haemofiltration or haemodialysis and no mortality. Only six patients (13%) were treated conservatively and 39 (87%) surgically. Dressing changes under general anaesthesia were preferred in Helsinki (37 times) and especially in the paediatric hospital (32 times) compared to Kuopio (7 times). Allografts were used only in Helsinki in 4 patients whereas artificial skin was used only in Kuopio in 15 patients. The overall cost of care was very similar in both centres being 1292-1425 euros per hospital day.

There were some small differences between the two burn centres in treatment policies. Most patients were male and most common aetiology was scald. The prognosis of these patients was excellent with no mortality.