Accession Number:

ADA616802

Title:

Correlation of American Burn Association Sepsis Criteria With the Presence of Bacteremia in Burned Patients Admitted to the Intensive Care Unit

Descriptive Note:

Journal article

Corporate Author:

ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX

Personal Author(s):

• Hogan, Brian K.
• Wolf, Steven E.
• Hospenthal, Duane R.
• D'Avignon, Laurie C.
• Chung, Kevin K.
• Yun, Heather C.
• Mann, Elizabeth A.
• Murray, Clinton K.

Report Date:

2012-06-01

Pagination or Media Count:

9.0

Abstract:

Severe burn injury is accompanied by a systemic inflammatory response, making traditional indicators of sepsis both insensitive and nonspecific. To address this, the American Burn Association ABA published diagnostic criteria in 2007 to standardize the definition of sepsis in these patients. These criteria include temperature 39 C or 36 C, progressive tachycardia 110 beats per minute, progressive tachypnea 25 breaths per minute not ventilated or minute ventilation 12 Lminute ventilated, thrombocytopenia 100,000ml not applied until 3 days after initial resuscitation, hyperglycemia untreated plasma glucose 200 mgdl, 7 units of insulinhr intravenous drip, or 25 increase in insulin requirements over 24 hours, and feed intolerance 24 hours abdominal distension, residuals two times the feeding rate, or diarrhea 2500 mlday. Meeting 3 of these criteria should trigger concern for infection. In this initial assessment of the ABA sepsis criteria correlation with infection, the authors evaluated the ABA sepsis criteria s correlation with bacteremia because bacteremia is not associated with inherent issues of diagnosis as occurs with pneumonia or soft tissue infections, and blood cultures are typically obtained due to concern for ongoing infections falling within the definition of septic. A retrospective electronic records review was performed to evaluate episodes of bacteremia in the United States Army Institute of Research from 2006 through 2007. A total of 196 patients were admitted during the study period who met inclusion criteria. The first positive and negative cultures, if present, from each patient were evaluated. This totaled 101 positive and 181 negative cultures. Temperature, heart rate, insulin resistance, and feed intolerance criteria were significant on univariate analysis.

Descriptors:

• *BACTEREMIA
• *BURNS(INJURIES)
• *SEPSIS
• BLOOD ANALYSIS
• CORRELATION
• INTENSIVE CARE UNITS

Subject Categories:

• Medicine and Medical Research

Distribution Statement:

APPROVED FOR PUBLIC RELEASE