Selective Digestive Decontamination Attenuates Organ Dysfunction in Critically Ill Burn Patients

Objective: To evaluate whether selective decontamination of the digestive tract (SDD) attenuates organ dysfunction in critically ill burn patients. Background: The effect of SDD on the development and progression of organ dysfunction, as an important determinant of mortality in burned patients, is s...

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Autores: López Rodríguez, Lucía, Cal, Miguel A. de la, García Hierro, Paloma, Herrero, Raquel, Martins Muñoz, Judith Fátima, Van Saene, Hendrick K. F., Lorente Balanza, José Ángel
Tipo de recurso: artículo
Fecha de publicación:2016
País:España
Institución:Universidad Europea (UEM)
Repositorio:ABACUS. Repositorio de Producción Científica
Idioma:inglés
OAI Identifier:oai:abacus.universidadeuropea.com:11268/9089
Acceso en línea:http://hdl.handle.net/11268/9089
Access Level:acceso abierto
Palabra clave:Fracaso multiorgánico
Quemaduras
Enfermedad de la piel
Lucha contra las enfermedades
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spelling Selective Digestive Decontamination Attenuates Organ Dysfunction in Critically Ill Burn PatientsLópez Rodríguez, LucíaCal, Miguel A. de laGarcía Hierro, PalomaHerrero, RaquelMartins Muñoz, Judith FátimaVan Saene, Hendrick K. F.Lorente Balanza, José ÁngelFracaso multiorgánicoQuemadurasEnfermedad de la pielLucha contra las enfermedadesObjective: To evaluate whether selective decontamination of the digestive tract (SDD) attenuates organ dysfunction in critically ill burn patients. Background: The effect of SDD on the development and progression of organ dysfunction, as an important determinant of mortality in burned patients, is still unknown. We asked whether organ dysfunction is mitigated by treatment with SDD. Methods: Patients with burns >20% of total body surface or suspected inhalation injury from a randomized placebo-controlled trial were analyzed to determine the relationship between treatment received (placebo or SDD) and the severity of organ dysfunction as measured by the area under the curve of the Sequential Organ Failure Assessment (SOFA) score (and its individual components) from day 1 to day 7 of admission. Results: One hundred seven patients (53 in the SDD group and 54 in the placebo group) were included. Survival was significantly higher in SDD-treated patients (48 of 53, 90.6%) than in placebo-treated patients (39 of 54, 72.2%, P = 0.013). Total (P < 0.01) and respiratory (P < 0.01), cardiovascular (P = 0.04) and hematological (not reaching statistical significance, P = 0.07) organ dysfunction was associated with mortality after adjusting for predicted mortality. In multivariate logistic regression, SDD treatment was independently associated with total (P < 0.01), respiratory (P = 0.02), and hematological (P < 0.01) dysfunction over the first week postinjury. Conclusions: The beneficial effect of SDD on mortality in critically ill burned patients is accompanied by a reduction in the degree of organ dysfunction. SDD seems to be a valuable therapeutic strategy to prevent organ dysfunction and, more specifically, respiratory and hematological dysfunction in severely ill burn patients.20202020-08-0520162016-01-0120162016-01-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articlehttp://hdl.handle.net/11268/9089reponame:ABACUS. Repositorio de Producción Científicainstname:Universidad Europea (UEM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:abacus.universidadeuropea.com:11268/90892026-06-11T12:41:27Z
dc.title.none.fl_str_mv Selective Digestive Decontamination Attenuates Organ Dysfunction in Critically Ill Burn Patients
title Selective Digestive Decontamination Attenuates Organ Dysfunction in Critically Ill Burn Patients
spellingShingle Selective Digestive Decontamination Attenuates Organ Dysfunction in Critically Ill Burn Patients
López Rodríguez, Lucía
Fracaso multiorgánico
Quemaduras
Enfermedad de la piel
Lucha contra las enfermedades
title_short Selective Digestive Decontamination Attenuates Organ Dysfunction in Critically Ill Burn Patients
title_full Selective Digestive Decontamination Attenuates Organ Dysfunction in Critically Ill Burn Patients
title_fullStr Selective Digestive Decontamination Attenuates Organ Dysfunction in Critically Ill Burn Patients
title_full_unstemmed Selective Digestive Decontamination Attenuates Organ Dysfunction in Critically Ill Burn Patients
title_sort Selective Digestive Decontamination Attenuates Organ Dysfunction in Critically Ill Burn Patients
dc.creator.none.fl_str_mv López Rodríguez, Lucía
Cal, Miguel A. de la
García Hierro, Paloma
Herrero, Raquel
Martins Muñoz, Judith Fátima
Van Saene, Hendrick K. F.
Lorente Balanza, José Ángel
author López Rodríguez, Lucía
author_facet López Rodríguez, Lucía
Cal, Miguel A. de la
García Hierro, Paloma
Herrero, Raquel
Martins Muñoz, Judith Fátima
Van Saene, Hendrick K. F.
Lorente Balanza, José Ángel
author_role author
author2 Cal, Miguel A. de la
García Hierro, Paloma
Herrero, Raquel
Martins Muñoz, Judith Fátima
Van Saene, Hendrick K. F.
Lorente Balanza, José Ángel
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv Fracaso multiorgánico
Quemaduras
Enfermedad de la piel
Lucha contra las enfermedades
topic Fracaso multiorgánico
Quemaduras
Enfermedad de la piel
Lucha contra las enfermedades
description Objective: To evaluate whether selective decontamination of the digestive tract (SDD) attenuates organ dysfunction in critically ill burn patients. Background: The effect of SDD on the development and progression of organ dysfunction, as an important determinant of mortality in burned patients, is still unknown. We asked whether organ dysfunction is mitigated by treatment with SDD. Methods: Patients with burns >20% of total body surface or suspected inhalation injury from a randomized placebo-controlled trial were analyzed to determine the relationship between treatment received (placebo or SDD) and the severity of organ dysfunction as measured by the area under the curve of the Sequential Organ Failure Assessment (SOFA) score (and its individual components) from day 1 to day 7 of admission. Results: One hundred seven patients (53 in the SDD group and 54 in the placebo group) were included. Survival was significantly higher in SDD-treated patients (48 of 53, 90.6%) than in placebo-treated patients (39 of 54, 72.2%, P = 0.013). Total (P < 0.01) and respiratory (P < 0.01), cardiovascular (P = 0.04) and hematological (not reaching statistical significance, P = 0.07) organ dysfunction was associated with mortality after adjusting for predicted mortality. In multivariate logistic regression, SDD treatment was independently associated with total (P < 0.01), respiratory (P = 0.02), and hematological (P < 0.01) dysfunction over the first week postinjury. Conclusions: The beneficial effect of SDD on mortality in critically ill burned patients is accompanied by a reduction in the degree of organ dysfunction. SDD seems to be a valuable therapeutic strategy to prevent organ dysfunction and, more specifically, respiratory and hematological dysfunction in severely ill burn patients.
publishDate 2016
dc.date.none.fl_str_mv 2016
2016-01-01
2016
2016-01-01
2020
2020-08-05
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/11268/9089
url http://hdl.handle.net/11268/9089
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
dc.source.none.fl_str_mv reponame:ABACUS. Repositorio de Producción Científica
instname:Universidad Europea (UEM)
instname_str Universidad Europea (UEM)
reponame_str ABACUS. Repositorio de Producción Científica
collection ABACUS. Repositorio de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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