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Erschienen in:
18.05.2017 | Original Paper
Continuous veno-venous haemodiafiltration in burns patients: a role in hyperpyrexia
Erschienen in: European Journal of Plastic Surgery | Ausgabe 1/2018
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Background
A burn injury results in the release of proinflammatory cytokines and catecholamines, causing a hypermetabolic state which may lead to hyperpyrexia (>40 °C). This risk is increased with concomitant sepsis. Hyperpyrexia is associated with a high mortality. Continous veno-venous haemodiafiltration (CVVHDF) can be used to reduce the circulating cytokines thereby reducing the cause of the hyperpyrexia. CVVHDF use has been well documented in sepsis and SIRS in the ITU population. In our Burns Centre, CVVHDF is routinely used to treat patients with persistent hyperpyrexia. The aim of this study was to evaluate the role of CVVHDF in burns patients with hyperpyrexia.
Methods
A retrospective analysis was carried out of all patients admitted to the Burns ITU between 2005 and 2012 who received CVVHDF for hyperpyrexia. The medical notes and electronic database was used to collect data on indication, renal function, duration and outcome.
Results
Five hundred seventy patients were admitted over the time period. Sixty-one patients received CVVHDF overall and of these 32 were for hyperpyrexia alone. In these patients, there was a significant reduction in temperature within 3 h of initiating CVVHDF (p < 0.0001). The cumulative predicted mortality using Modified Baux score was seven patients. In our group 2 patients died, possibly implying a survival benefit.
Conclusions
CVVHDF can be successfully used to regulate the temperature in burns patients with hyperpyrexia.
Level of evidence: Level IV, therapeutic study.