An eighteen-year review of intensive care requirements for paediatric burns in a regional burns service

• Published in: Journal of plastic, reconstructive & aesthetic surgery Vol. 91; pp. 258 - 267
• Main Authors: Bickerton, Shixin, Nizamoglu, Metin, Emamdee, Russel, Frew, Quentin, Borrows, Emma, Bangalore, Harish, Hussey, Joseph, Khan, Waseemullah, Martin, Niall, Barnes, David, El-Muttardi, Naguib, Shelley, Odhran P., Dziewulski, Peter
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.04.2024
• Subjects: Adolescent; Burn Units; Burns; Burns - complications; Child; Complications; Critical Care; Hospitalization; Humans; Intensive care; Intensive Care Units; Length of Stay; Organ support; Outcomes; Paediatric; Retrospective Studies; PaCO2; Paediatric; Intensive care; Organ support; HFOV; Complications; CI; IQR; APACHE II; PRISM; Outcomes; LOS; PaO2; SIRS; R; TPN; PIM; GCS; IBID; ICU; TBSA; Burns; ARDS
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2024.02.023

Advances in burns management have reduced mortality. Consequently, efficient resource management plays an increasingly important role in improving paediatric burns care. This study aims to assess the support requirements and outcomes of paediatric burns patients admitted to a burns centre intensive care unit in comparison to established benchmarks in burns care. A retrospective review of burns patients under the age of 16 years old, admitted to a regional burns service intensive care unit between March 1998 and March 2016 was conducted. Our analysis included 234 patients, with the percentage of TBSA affected by burn injury ranging from 1.5% to 95.0%. The median (IQR) %TBSA was 20.0% (11.0–30.0), and the observed mortality rate was 2.6% (6/234). The median (IQR) length of stay was 0.7 days/%TBSA burn (0.4–1.2), 17.9% (41/229) required circulatory support and 2.6% (6/234) required renal replacement. Mortality correlated with smoke inhalation injury (P < 0.001), %TBSA burn (P = 0.049) and complications (P = 0.004) including infections (P = 0.013). Among children with burn injuries who require intensive care, the presence of inhalational injury and the diagnosis of infection are positively correlated with mortality. Understanding the requirements for organ support can facilitate a more effective allocation of resources within a burns service.