Burn edema and protein leakage in the rat

Brouhard, Ben H.; Carvajal, Hugo F.; Linares, Hugo A.

doi:10.1016/0026-2862(78)90020-1

Cited by 60 publications

(11 citation statements)

References 12 publications

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“…These skin injuries induce a strong inflammatory response and the release of vasoactive substances, which increases the skin permeability to water, albumin, and even larger protein molecules (21,30–32). This process peaks during the first 12–24 hours, coupled with a reduction in the albumin mRNA response to the burn and an increased synthesis and accumulation of acute-phase reactants.…”

Section: Discussionmentioning

confidence: 99%

Serum albumin level as a risk factor for mortality in burn patients

Aguayo-Becerra¹,

Torres-Garibay²,

Macías-Amezcua³

et al. 2013

Clinics

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OBJECTIVE:Hypoalbuminemia is a common clinical deficiency in burn patients and is associated with complications related to increased extravascular fluid, including edema, abnormal healing, and susceptibility to sepsis. Some prognostic scales do not include biochemical parameters, whereas others consider them together with comorbidities. The purpose of this study was to determine whether serum albumin can predict mortality in burn patients.METHODS:We studied burn patients ≥16 years of age who had complete clinical documentation, including the Abbreviated Burn Severity Index, serum albumin, globulin, and lipids. Sensitivity and specificity analyses were performed to determine the cut-off level of albumin that predicts mortality.RESULTS:In our analysis of 486 patients, we found that mortality was higher for burns caused by flame (p = 0.000), full-thickness burns (p = 0.004), inhalation injuries (p = 0.000), burns affecting >30% of the body surface area (p = 0.001), and burns associated with infection (p = 0.008). Protein and lipid levels were lower in the patients who died (p<0.05). Albumin levels showed the highest sensitivity and specificity (84% and 83%, respectively), and the area under the receiver-operating characteristic curve (0.869) had a cut-off of 1.95 g/dL for mortality.CONCLUSION:Patients with albumin levels <2 g/dL had a mortality risk of >80%, with 84% sensitivity and 83% specificity. At admission, the albumin level could be used as a sensitive and specific marker of burn severity and an indicator of mortality.

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Section: Discussionmentioning

confidence: 99%

Serum albumin level as a risk factor for mortality in burn patients

Aguayo-Becerra¹,

Torres-Garibay²,

Macías-Amezcua³

et al. 2013

Clinics

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“…Brouhard et al reported increased water content in nonburned skin even after a 10% burn, with the maximum increase occurring at 12-hour postburn [31]. Maximum increased lymph flow and tissue water content were observed to correlate with the severe hypoproteinemia occurring during the early resuscitation period of a 40% burn injury in sheep [20,32].…”

Section: Non-burned Tissuementioning

confidence: 95%

“…However, it is not known if either the correction of hypoproteinemia or the use of albumin or dextran can lead to improved clinical outcome. It has been reported that the use of colloids has no beneficial effect on edema in the burn wound [31,32]. Use of hypertonic saline formulations as initial fluid therapies of burn shock can dramatically reduce initial volume requirements and net fluid volume (infused minus urine out) [39,40].…”

Section: Non-burned Tissuementioning

confidence: 99%

Pathophysiology of burns

Keck

Herndon

Kamolz

et al. 2009

Wien Med Wochenschr

111

112

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Burn injury represents a significant problem worldwide. Advances in therapy strategies, based on better understanding of the pathophysiologic responses after burn injury have improved the clinical outcome of patients with burn injuries over the past years. This article describes the present understanding of the pathophysiology of a burn injury including both the local and systemic responses, focusing on the many facets of organ and systemic effects directly resulting from hypovolemia and circulating mediators following burn trauma.

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“…Burn injury to skin initiates an intense inflammatory response and release of vasoactive agents, increasing capillary permeability to fluid, albumin and even larger proteins at the burn site [16]. This process reaches its peak in 12-24 h. Albumin has clearly been shown to leak from the intravascular space during at least the first 6-18 h after injury [17,18]. Besides, examination of the livers of burned animals reveals that the messenger RNA for albumin is decreased in response to injury [19,20], a response that is associated with the increase in acute phase reactants.…”

Section: Discussionmentioning

confidence: 99%

Impact of Burn Size and Initial Serum Albumin Level on Acute Renal Failure Occurring in Major Burn

Kim¹,

Oh²,

Yoon³

et al. 2002

Am J Nephrol

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Background: Acute renal failure (ARF) is not a rare occurrence in severe burns and is an important complication leading to an increase in mortality. The severity of the burn is largely determined by the burn size, and severe burns are likely to cause enough loss of extracellular fluid and albumin from plasma volume to produce shock and hypoalbuminemia. Hypothesis: We hypothesized that initial serum albumin level may be useful as an indicator of prognosis and severity of injury in burned patients. Methods: The clinical characteristics of 147 adult patients with second- and third-degree burns covering 30% or more of their body surface area were analyzed retrospectively. Logistic regression was used to estimate the relative risks of ARF and mortality associated with the larger burn size and the lower serum albumin level at admission. Results: Mean burned body surface was 60.0 ± 21.8% (range 30–100%). Twenty-eight (19.0%) out of 147 patients experienced ARF, defined as a serum creatinine ≧2 mg/dl, during the admission. The patients with ARF had larger burn size (79.5 ± 15.4 vs. 55.3 ± 20.5%, p < 0.0001) and lower serum albumin concentration at admission (1.92 ± 0.66 vs. 2.48 ± 0.82 g/dl, p < 0.0005) compared with those without ARF. All patients with ARF expired, whereas 29.4% (35/119) of the patients without ARF died. The burn size ≧65% was associated with a risk of ARF that was 9.9 times and with a risk of death that was 14.2 times as high as that for the burn size <65%. The initial serum albumin level <2.5 g/dl was associated with a risk of death that was 2.7 times as high as that for the initial serum albumin level ≧2.5 g/dl. Conclusions: When major burns are complicated by ARF, the mortality rate increases significantly. Burn size is an independent predictor of ARF occurring in major burns. Initially depressed serum albumin level is associated with an increase in mortality in the major burn patients.

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Burn edema and protein leakage in the rat

Cited by 60 publications

References 12 publications

Serum albumin level as a risk factor for mortality in burn patients

Serum albumin level as a risk factor for mortality in burn patients

Pathophysiology of burns

Impact of Burn Size and Initial Serum Albumin Level on Acute Renal Failure Occurring in Major Burn

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