ABSTRACT
After a burn lesion, Acute Respiratory Distress Syndrome (ARDS) may occur via direct lung injury due to inhaled smoke and fumes or mediated by the inflammatory response associated with the burn or its infectious complications. The aim of the present study is to assess the epidemiologic profile of ARDS in adult burn patients admitted to intensive care in a burn unit at a university hospital. A prospective cohort study was performed from January to December 2012. Demographic and diagnostic data, prognostic scores, etiology and data on the extent and depth of burns were collected. Data related to risk factors for ARDS and death were also recorded. A total of 85 patients were included in the study. Patients were aged 41.7 (SD = 15.7) years old; 71.8% were male and the mean total body surface area burned was 28.3% (SD = 19.1%); 35.3% presented inhalation injuries. Invasive ventilatory support was required in 44 ICU inpatients (51.8%). ARDS was diagnosed in 38.6% of patients under invasive mechanical ventilation. In multivariate analysis, the presence of inhalation injuries was a risk factor for ARDS (OR = 9.75; CI 95% 2.79 - 33.95; P < 0.001). ARDS is a common complication in burn patients admitted to specialized intensive care units. Inhalation injuries were an independent risk factor for ARDS. Mortality rate observed in the study patients was high and associated with ARDS diagnosis.
Après une brûlure, un SDRA peut survenir soit en raison d'une atteinte pulmonaire directe (inhalation de fumées) soit en raison de la réaction inflammatoire due à la brûlure ou à une complication infectieuse. Le but de ce travail est d'évaluer l'épidémiologie des SDRA survenus chez des adultes brûlés hospitalisés dans l'unité de réanimation dédiée d'un CHU durant l'année 2012. Les données démographiques, celles concernant la brûlure (cause, étendue, profondeur, scores pronostics) et les facteurs de risque de SDRA ont été relevés. Quatre vingt cinq patients ont été inclus. Les patients étaient âgés de 41,7+/-15,7 ans, 71,8% d'entre eux étaient des hommes, ils étaient brûlés sur 28,3+/-19,1% de la SCT, 35,3% d'entre eux avaient des lésions d'inhalation. Quarante quatre patients (51,8%) ont eu besoin de ventilation mécanique. Un SDRA a été diagnostiqué chez 38,6% des patients ventilés. En analyse multivariée, les lésions d'inhalation sont un facteur de risque de SDRA (OR 9,75 ; IC95 2,79-33,95 ; p<0,001). Le SDRA est une complication fréquente chez les brûlés admis en unité de réanimation spécialisée. Les lésions d'inhalation sont un facteur de risque indépendant de SDRA. La mortalité de la cohorte était élevée, et associée au diagnostic de SDRA.
ABSTRACT
A survey of childhood blindness in Peruvian children was done. Although most causes of blindness were due to congenital and hereditary conditions, measles accounted for almost 10% of blindness. With widespread measles immunization, this preventable cause of blindness in children can be eliminated or dramatically reduced.
