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EXTRAVASCULAR LUNG WATER IS A PREDICTOR OF DEVELOPMENT OF MULTIPLE ORGAN FAILURE IN CHILDREN WITH SEVERE BURN INJURY

A U Lekmanov, D K Azovskiy, S F Pilyutik

    Anesteziologiia I Reanimatologiia
    |June 23, 2018
    PubMed

    Insights

    Increased extravascular lung water (EVLW) levels in pediatric burn patients reliably predict multiple organ failure (MOF). This finding suggests EVLW is a valuable prognostic factor for MOF in severe burn injuries.

    Area of Science:

    • Pediatric critical care medicine
    • Burn injury management
    • Hemodynamic monitoring

    Background:

    • Severe burn injuries in children can lead to multiple organ failure (MOF).
    • Early identification of patients at risk for MOF is crucial for timely intervention.

    Purpose of the Study:

    • To investigate if elevated extravascular lung water (EVLW) levels predict MOF in pediatric patients with severe burns.
    • To assess the prognostic value of EVLW in this patient population.

    Main Methods:

    • A prospective study involving 33 pediatric patients with 30-90% total body surface area burns admitted to the PICU.
    • Continuous hemodynamic monitoring using PICCO technology, including EVLW measurements every 6 hours for 48 hours.
    • MOF diagnosis based on the DENVER II score.

    Main Results:

    • Normal weight-indexed extravascular lung water index (ELWI) values vary by age: 9-29 ml/kg (<1 year), 7-25 ml/kg (1-5 years), and 5-13 ml/kg (>5 years).
    • Height-indexed ELWI up to 315 ml/m was considered normal.
    • Height-indexed ELWI reliably correlated with the rate of multiple organ dysfunction syndrome (MODS) across all measurements.

    Conclusions:

    • Extravascular lung water index (ELWI) is a reliable prognostic factor for predicting multiple organ dysfunction syndrome (MODS) in pediatric burn patients.
    • No correlation was found between the surface area of burned skin and EVLW levels.
    Abstract

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