Prognostication of the development of septic complications in children with burn injuries

Area of Science:

• Pediatric critical care medicine
• Burn management
• Infectious disease epidemiology

Background:

• Sepsis is a significant complication in pediatric burn patients.
• Early identification of at-risk children is vital for effective treatment.
• Prognostic factors for sepsis development in pediatric thermal injury require further elucidation.

Purpose of the Study:

• To identify prognostic criteria for septic complications in children with thermal injury.
• To establish reliable predictors for early sepsis detection in pediatric burn patients.

Main Methods:

• A retrospective-prospective cohort study involving 98 children with severe burns (2007-2017).
• A prospective study of 63 pediatric burn patients (ages 1-5) from 2018-2021.
• Analysis of burn characteristics, damage severity index, and biomarker levels (procalcitonin, C-reactive protein).

Main Results:

• High risk of sepsis associated with flame burns, damage severity index ≥75, total burn surface ≥25%, and deep burn area ≥5%.
• Procalcitonin (PCT) thresholds (≥0.86 ng/ml on days 1-3, >0.51 ng/ml on day 7) predict sepsis probability.
• C-reactive protein (CRP) levels (>6.98 ng/ml on day 1, >7.43 ng/ml on day 3, >7.28 ng/ml on day 7) indicate sepsis risk.

Conclusions:

• Established prognostic criteria enable early prediction of sepsis in pediatric burn patients.
• These criteria facilitate timely intervention, potentially improving patient outcomes.
• The findings support the integration of these biomarkers and clinical factors into burn care protocols.