Renal Replacement Therapy in Severe Burns: A Multicenter Observational Study

Randomized controlled Evaluation of high-volume hemofiltration in adult burn patients with Septic shoCk and acUte kidnEy injury (RESCUE) Investigators

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Acute kidney injury (AKI) after severe burns is historically associated with a high mortality. Over the past two decades, various modes of renal replacement therapy (RRT) have been used in this population. The purpose of this multicenter study was to evaluate demographic, treatment, and outcomes data among severe burn patients treated with RRT collectively at various burn centers around the United States. After institutional review board approval, a multicenter observational study was conducted. All adult patients aged 18 or older, admitted with severe burns who were placed on RRT for acute indications but not randomized into a concurrently enrolling interventional trial, were included. Across eight participating burn centers, 171 subjects were enrolled during a 4-year period. Complete data were available in 170 subjects with a mean age of 51 ± 17, percent total body surface area burn of 38 ± 26% and injury severity score of 27 ± 21. Eighty percent of subjects were male and 34% were diagnosed with smoke inhalation injury. The preferred mode of therapy was continuous venovenous hemofiltration at a mean delivered dose of 37 ± 19 (ml/kg/hour) and a treatment duration of 13 ± 24 days. Overall, in hospital, mortality was 50%. Among survivors, 21% required RRT on discharge from the hospital while 9% continued to require RRT 6 months after discharge. This is the first multicenter cohort of burn patients who underwent RRT reported to date. Overall mortality is comparable to other critically ill populations who undergo RRT. Most patients who survive to discharge eventually recover renal function.

Original languageEnglish (US)
Pages (from-to)1017-1021
Number of pages5
JournalJournal of burn care & research : official publication of the American Burn Association
Volume39
Issue number6
DOIs
StatePublished - Oct 23 2018
Externally publishedYes

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Renal Replacement Therapy
Burns
Multicenter Studies
Observational Studies
Burn Units
Smoke Inhalation Injury
Hemofiltration
Injury Severity Score
Mortality
Research Ethics Committees
Body Surface Area
Hospital Mortality
Acute Kidney Injury
Critical Illness
Population
Survivors
Demography
Kidney
Therapeutics

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Rehabilitation

Cite this

Randomized controlled Evaluation of high-volume hemofiltration in adult burn patients with Septic shoCk and acUte kidnEy injury (RESCUE) Investigators (2018). Renal Replacement Therapy in Severe Burns: A Multicenter Observational Study. Journal of burn care & research : official publication of the American Burn Association, 39(6), 1017-1021. https://doi.org/10.1093/jbcr/iry036

Renal Replacement Therapy in Severe Burns : A Multicenter Observational Study. / Randomized controlled Evaluation of high-volume hemofiltration in adult burn patients with Septic shoCk and acUte kidnEy injury (RESCUE) Investigators .

In: Journal of burn care & research : official publication of the American Burn Association, Vol. 39, No. 6, 23.10.2018, p. 1017-1021.

Research output: Contribution to journalArticle

Randomized controlled Evaluation of high-volume hemofiltration in adult burn patients with Septic shoCk and acUte kidnEy injury (RESCUE) Investigators 2018, 'Renal Replacement Therapy in Severe Burns: A Multicenter Observational Study', Journal of burn care & research : official publication of the American Burn Association, vol. 39, no. 6, pp. 1017-1021. https://doi.org/10.1093/jbcr/iry036
Randomized controlled Evaluation of high-volume hemofiltration in adult burn patients with Septic shoCk and acUte kidnEy injury (RESCUE) Investigators . Renal Replacement Therapy in Severe Burns: A Multicenter Observational Study. Journal of burn care & research : official publication of the American Burn Association. 2018 Oct 23;39(6):1017-1021. https://doi.org/10.1093/jbcr/iry036
Randomized controlled Evaluation of high-volume hemofiltration in adult burn patients with Septic shoCk and acUte kidnEy injury (RESCUE) Investigators . / Renal Replacement Therapy in Severe Burns : A Multicenter Observational Study. In: Journal of burn care & research : official publication of the American Burn Association. 2018 ; Vol. 39, No. 6. pp. 1017-1021.
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abstract = "Acute kidney injury (AKI) after severe burns is historically associated with a high mortality. Over the past two decades, various modes of renal replacement therapy (RRT) have been used in this population. The purpose of this multicenter study was to evaluate demographic, treatment, and outcomes data among severe burn patients treated with RRT collectively at various burn centers around the United States. After institutional review board approval, a multicenter observational study was conducted. All adult patients aged 18 or older, admitted with severe burns who were placed on RRT for acute indications but not randomized into a concurrently enrolling interventional trial, were included. Across eight participating burn centers, 171 subjects were enrolled during a 4-year period. Complete data were available in 170 subjects with a mean age of 51 ± 17, percent total body surface area burn of 38 ± 26{\%} and injury severity score of 27 ± 21. Eighty percent of subjects were male and 34{\%} were diagnosed with smoke inhalation injury. The preferred mode of therapy was continuous venovenous hemofiltration at a mean delivered dose of 37 ± 19 (ml/kg/hour) and a treatment duration of 13 ± 24 days. Overall, in hospital, mortality was 50{\%}. Among survivors, 21{\%} required RRT on discharge from the hospital while 9{\%} continued to require RRT 6 months after discharge. This is the first multicenter cohort of burn patients who underwent RRT reported to date. Overall mortality is comparable to other critically ill populations who undergo RRT. Most patients who survive to discharge eventually recover renal function.",
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