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Predicting fatal sepsis
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Law M. P., Coultas P. G. and Field S. B. (1979) Induced thermal resistance in the mouse ear. Br. J. Radiol. 52, 308.
Red cell filterability Erythrocyte filterability was measured in a group of 6 simultaneously burned patients with burned areas exceeding 30 per cent of the body surface. The mean filterability time was prolonged in the burned patients (25'0 _+ 16"9 s/ml) when compared with the normal of 4'0 _+ 1"0 s/ml, indicating a decrease in deformability of the red cells. Except for a low red cell potassium and high white blood cell count this change in filterability could not be correlated with other serum or erythrocyte biochemical and physical characteristics studied. With adequate resuscitation the filterability returned to normal in 3 days. Johnson G., Lineberger T., Hothem A. L. et al. (1979) Erythrocyte filterability in the burned patient. Burns 6, 91.
Bacteria in burn biopsies Sequential paired punch biopsy samples were taken from three separate locations on each of 4 burn patients with burns covering between 40 and 67 per cent of the body surface, and measurements were made of the number of viable bacteria per gramme of tissue. The range (log~0 0'02 to 1"51) and the s.d. (log~0 0'67) were determined for each pair of observations. The 95 per cent confidence interval based on any single observation (x) was found to be x ± 1'31. It was concluded that the burn wound biopsy is a reliable procedure for quantitating organisms in a burn wound
Burns Vol, 6/No. 4
and that changes in sequential samples give an indication of the dynamics of infection in the burn patients. Volenec F. J., Clark G. M., Mani M. M. etal. (1979) Burn wound biopsy bacterial quantitation, a statistical analysis. Am. J. Surg. 138,695.
Predicting fatal sepsis To test whether the high morbidity of severe burns is related partially to a decrease in immunocompetence, measurements were made of the ability of phytohaemagglutinin and concanavalin to stimulate lymphocyte transformation in 17 patients with burns covering more than 25 per cent of the body surface. Eight acutely burned patients who subsequently developed severe sepsis had lymphocytes with a decreased ability (only 12 per cent of normal) to proliferate in response to phytohaemagglutinin and concanavalin, and 6 of the patients died of septicaemia. The depressed responses appeared 4-7 days after burning and predated clinical evidence of sepsis by 2-4 days. Lymphocytes from 4 patients who had mild infectious complications showed greatly augmented (almost two and a half times normal) mitogen responses approximately 7-10 days after burning. Five burned patients whose clinical course was free from sepsis showed only minimal changes in their mitogen responses. Thus the appearance of a decreased mitogen-induced proliferation of lymphocytes is characteristic of those patients who are unlikely to survive an episode of severe septicaemia. Baker C. C., Miller C. L. and Trunkey D. D. (1979) Predicting fatal sepsis in burn patients. J. Trauma 19, 641.
Law M. P., Coultas P. G. and Field S. B. (1979) Induced thermal resistance in the mouse ear. Br. J. Radiol. 52, 308.
Red cell filterability Erythrocyte filterability was measured in a group of 6 simultaneously burned patients with burned areas exceeding 30 per cent of the body surface. The mean filterability time was prolonged in the burned patients (25'0 _+ 16"9 s/ml) when compared with the normal of 4'0 _+ 1"0 s/ml, indicating a decrease in deformability of the red cells. Except for a low red cell potassium and high white blood cell count this change in filterability could not be correlated with other serum or erythrocyte biochemical and physical characteristics studied. With adequate resuscitation the filterability returned to normal in 3 days. Johnson G., Lineberger T., Hothem A. L. et al. (1979) Erythrocyte filterability in the burned patient. Burns 6, 91.
Bacteria in burn biopsies Sequential paired punch biopsy samples were taken from three separate locations on each of 4 burn patients with burns covering between 40 and 67 per cent of the body surface, and measurements were made of the number of viable bacteria per gramme of tissue. The range (log~0 0'02 to 1"51) and the s.d. (log~0 0'67) were determined for each pair of observations. The 95 per cent confidence interval based on any single observation (x) was found to be x ± 1'31. It was concluded that the burn wound biopsy is a reliable procedure for quantitating organisms in a burn wound
Burns Vol, 6/No. 4
and that changes in sequential samples give an indication of the dynamics of infection in the burn patients. Volenec F. J., Clark G. M., Mani M. M. etal. (1979) Burn wound biopsy bacterial quantitation, a statistical analysis. Am. J. Surg. 138,695.
Predicting fatal sepsis To test whether the high morbidity of severe burns is related partially to a decrease in immunocompetence, measurements were made of the ability of phytohaemagglutinin and concanavalin to stimulate lymphocyte transformation in 17 patients with burns covering more than 25 per cent of the body surface. Eight acutely burned patients who subsequently developed severe sepsis had lymphocytes with a decreased ability (only 12 per cent of normal) to proliferate in response to phytohaemagglutinin and concanavalin, and 6 of the patients died of septicaemia. The depressed responses appeared 4-7 days after burning and predated clinical evidence of sepsis by 2-4 days. Lymphocytes from 4 patients who had mild infectious complications showed greatly augmented (almost two and a half times normal) mitogen responses approximately 7-10 days after burning. Five burned patients whose clinical course was free from sepsis showed only minimal changes in their mitogen responses. Thus the appearance of a decreased mitogen-induced proliferation of lymphocytes is characteristic of those patients who are unlikely to survive an episode of severe septicaemia. Baker C. C., Miller C. L. and Trunkey D. D. (1979) Predicting fatal sepsis in burn patients. J. Trauma 19, 641.