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Related Experiment Videos

Lethal triad in severe burns.

P B Sherren1, J Hussey2, R Martin2

  • 1Department of Anaesthesia and Intensive Care, The Royal London Hospital, London, UK.

Burns : Journal of the International Society for Burn Injuries
|July 6, 2014
PubMed
Summary
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The lethal triad of hypothermia, acidaemia, and coagulopathy is present in 12.8% of major burn patients. This severe condition is linked to higher mortality, emphasizing the critical nature of these combined physiological derangements in burn injury.

Area of Science:

  • Trauma and Burn Surgery
  • Critical Care Medicine
  • Physiology

Background:

  • Hypothermia, acidaemia, and coagulopathy (the lethal triad) are associated with increased mortality in trauma patients.
  • The incidence and outcomes of the lethal triad in major burn injuries remain under-investigated.

Purpose of the Study:

  • To determine the incidence of the lethal triad in patients with major burns (Total Body Surface Area [TBSA] ≥ 30%).
  • To describe the demographic characteristics and outcomes of burn patients presenting with the lethal triad.

Main Methods:

  • A retrospective review of a prospective database was conducted for patients admitted over a 71-month period.
  • The lethal triad was defined as coagulopathy (INR > 1.2), hypothermia (temperature ≤ 35.5°C), and acidaemia (pH ≤ 7.25) upon admission.
Keywords:
Abbreviated burn severity index (ABSI)AcidaemiaBurnCoagulopathyHypothermia

Related Experiment Videos

  • Demographic data, injury severity scores (Abbreviated Burn Severity Index [ABSI]), TBSA, and mortality rates were analyzed.

    • Main Results:

    • Fifteen out of 117 (12.8%) major burn patients met the criteria for the lethal triad on admission.
    • Patients with the lethal triad exhibited significantly higher ABSI, TBSA burn, age, and incidence of inhalational and full-thickness burns.
    • The lethal triad was associated with a markedly higher mortality rate (66.7% vs. 13.7%, p<0.0001).

    Conclusions:

    • The presence of the lethal triad in major burn patients is associated with a high mortality rate.
    • This finding underscores the severity of the underlying burn injury and the critical physiological state of these patients.