TY  - JOUR
PY  - 2016//
TI  - Early coagulopathy is associated with increased incidence of ventilator-associated events among burn patients
JO  - Shock
A1  - Younan, Duraid
A1  - Griffin, Russell
A1  - Thompson, Maxwell
A1  - Swain, Thomas
A1  - Honkanen, Matthew
A1  - Crosby, James C.
A1  - Ellis, Chandra V.
A1  - Pittet, Jean- Francois
A1  - Kerby, Jeffrey D.
SP  - 107
EP  - 110
VL  - 47
IS  - 1
N2  - OBJECTIVE: Coagulopathy is known to be associated with burn injury. Our group has showed that, in spinal cord injury patients, coagulopathy is associated with an increase in VAP. We hypothesized that the same association exists between coagulopathic burn patients and ventilator associated events. <br><br>METHODS: Patients admitted for burn care between January 1, 2011 and December 31, 2015 who required mechanical ventilation were included in the study. Ventilator-associated events (VAEs) as defined by the Center for Disease Control were categorized as no event, ventilator-associated condition, infection-related ventilator-associated complication, and possible VAP. Demographic, injury characteristics were compared among four INR categories using analysis of variance and chi-square tests. <br><br>RESULTS: Four hundred and four patients were admitted for burn care, of which 263 met the inclusion criteria. 111 had normal INR, 59 had a slightly elevated INR (1.2-1.4), 33 had a moderately elevated INR (1.4-1.6), and 60 had a severely elevated INR (>1.6). Those with moderately and severely elevated INR were ventilated for a longer period (p = 0.0034), had more days in the ICU (p = 0.0010), and had longer hospital stay (p = 0.0016). After adjusting for inhalation injury and TBSA, patients with severely elevated INR were over 4 times as likely to have any VAE (OR: 4.16, 95%CI: 1.33-13.05) and 4.5 times as likely to develop IVAC or PVAP combined (OR: 4.59, 1.35-15.67). <br><br>CONCLUSIONS: Early coagulopathy is associated with a significantly increased incidence of VAEs in burn patients. While additional studies need to be conducted to verify these findings, early recognition and treatment could decrease VAEs.<p />  <p>Language: en</p>
LA  - en
SN  - 1073-2322
UR  - http://dx.doi.org/10.1097/SHK.0000000000000738
ID  - ref1
ER  -