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Vasopressor Use in Acute Burn Resuscitation: A Retrospective Study.

Kristine Knappskog1,2,3, Kostiantyn Botnar4, Julia Kleinhapl2,5

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Vasopressors are used in severe burn patients, but this study found their early use correlated with increased acute kidney injury and higher 30-day mortality rates. Careful consideration of vasopressor administration in burn care is warranted.

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Area of Science:

  • Critical Care Medicine
  • Burn Management
  • Pharmacology

Background:

  • Vasopressors are vital for managing hypotension in severe burn patients unresponsive to fluid resuscitation.
  • Understanding patient characteristics and outcomes associated with vasopressor use is crucial for optimizing care.

Purpose of the Study:

  • To characterize severe burn patients requiring vasopressors.
  • To investigate the association between early vasopressor administration and patient outcomes, including acute kidney injury and mortality.

Main Methods:

  • Retrospective analysis of de-identified electronic health records from the TriNetX Research Network (2010-2023).
  • Inclusion criteria: patients aged ≥18 years with burns ≥20% TBSA.
  • Propensity score matching (1:1 ratio) was used to compare patients receiving vasopressors within 2 days of admission versus those who did not.

Main Results:

  • 17.7% of 6872 severe burn patients received vasopressors early.
  • Vasopressor recipients were older, had more comorbidities, and sustained more severe burns.
  • Post-matching, early vasopressor use was linked to significantly higher rates of acute kidney injury (51.0% vs. 28.4%), sepsis (30.8% vs. 22.9%), and 30-day mortality (45.1% vs. 32.7%).

Conclusions:

  • Early vasopressor administration in severe burn patients is associated with increased risks.
  • Higher rates of early acute kidney injury and 30-day mortality were observed in patients receiving vasopressors.
  • Findings suggest a need for careful evaluation of vasopressor use in burn resuscitation protocols.