Vasopressor Use in Acute Burn Resuscitation: A Retrospective Study

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.