Trace Element Repletion Following Severe Burn Injury

Study Overview
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Brief Summary
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Major burn patients are characterized by large exudative losses of Cu, Se and Zn. Trace element (TE) repletion has been shown to improve clinical outcome. The study aimed to check if our repletion protocols were achieving normalization of TE plasma concentrations of major burn patients and if the necessity for continuous renal replacement therapy (CRRT) might increase the needs.

Detailed Description
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Retrospective analysis of prospectively collected data in burn patients requiring intensive care (ICU) between 1999 and 2015. The cohort was divided into 4 groups according to the protocol changes. Period 1 (P1): 1999-2000, P2: 2001-2005, P3: 2006-2010, P4: 2011-2015. Changes consisted mainly in increasing TE repletion doses and duration. Demographic data, daily TE intakes and weekly plasma concentrations were retrieved for the first 21 ICU-days.

Official Title
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Trace Element Repletion Following Severe Burn Injury

Conditions
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Critical Illness, Nutritional Deficiency, Trace Element Deficiency, Burn Injury

Intervention / Treatment
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* Other: Trace elements replacement


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Burn injury involving ≥20% body surface (TBSA) (i.e. the threshold for intravenous TE repletion prescription) At least one TE plasma concentration during the ICU stay Exclusion Criteria: Comfort care Admission >24h after burn injury

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 86 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Trace elements replacement|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Trace elements plasma concentration | Copper, Selenium and Zinc plasma concentrations, measured by inductively coupled plasma mass spectrometry (ICP-MS). The recommendation was to check them on a weekly basis. | 21 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of infectious complications | Infectious complications retrieved from the discharge reports, based on microbiological findings and antibiotherapy introduction or rotation. Multiple positive cultures were considered only once when they were related to a unique infectious episode. Concomitant sites of infection, including primary bloodstream infections, were considered as separate episodes of infections. Episodes of infections due to several microorganisms were considered only once. Infections were defined according to the criteria of the Center for Disease Control (CDC), American Burn Association (ABA) and International sepsis forum. | 21 days | 
| Length of mechanical ventilation | Number of days on the ventilator by the time the patient is discharged from hospital. | Up to 120 days | 
| Length of stay | Number of days spent in the ICU by the time the patient is discharged from hospital. | Up to 250 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Copper, Selenium, Zinc, Continuous renal replacement therapy