Cardiac dysfunction appears to be a major contributing factor in the death of patients with severe burns, say US researchers.
They said that, while larger burns were associated with higher mortality, the exact reasons for this had not been previously determined. They studied 189 paediatric patients with a range of burn sizes.
Patients with over 60% burns underwent a severe inflammatory and hypermetabolic response, the authors found. But a marked reduction in cardiac output was also observed in those with 80% burns, they said.
'Treatment should focus on several aspects of the pathophysiologic events postburn, such as treatment of the inflammatory response, insulin resistance, hypermetabolism, catabolism and cardiac dysfunction,' the authors said.
Critical Care (2007) 11: R90