A New Sepsis Scale for Burns: Correlation with Endotoxin and Host Response

  • A. M. Munster
  • M. Meek
  • R. A. Winchurch
  • C. Dickerson

Abstract

The measurement of surgical sepsis remains an unsolved problem. The use of positive blood cultures or would cultures has never been particularly satisfactory, except perhaps as an end point for the treatment of septicemia of surgical origin. With the realization that the host response, rather than the mere presence of bacteria, contribute to what is clinically seen as “the septic picture”, attempts have been made to develop sepsis scores which are based on measures of the host response as well as bacteriologic information. The additional measurement, using the new chromogenic Limulus lysate assay, of plasma endotoxin concentration adds another dimension to the evaluation of sepsis. The correlation between the induction of tumor necrosis factor and endotoxemia is well documented [1, 2, 3]. We have shown that burn size is well correlated with plasma endotoxin concentration [4], but the correlation of endotoxin concentration to the occurrence of sepsis in these patients has never been clearly shown. Border [5] used a sepsis scale to document the effect of enteral nutrition in intensive care patients. The popular APACHE II system [6] has been used by some authors for correlation with sepsis [7] but the APACHE II system was not designed for continuous measurement of sepsis, and although an excellent prognostic tool, it does not allow for some of the finer differential aspects seen in clinically septic patients.

Keywords

Hydrolysis Creatinine Titration Thymidine Polymyxin 

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Copyright information

© Springer-Verlag, Berlin Heidelberg 1993

Authors and Affiliations

  • A. M. Munster
    • 1
    • 2
  • M. Meek
    • 1
    • 2
  • R. A. Winchurch
    • 1
    • 2
  • C. Dickerson
    • 1
    • 2
  1. 1.Baltimore Regional Burn CenterFrancis Scott Key Medical CenterBaltimoreUSA
  2. 2.Department of SurgeryJohns Hopkins UniversityBaltimoreUSA

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