Effect of systemic inflammatory response in the development of encephalopathy in severe thermal injury.
DOI:
https://doi.org/10.26641/2307-0404.2015.4.56136Keywords:
burn, systemic inflammatory response syndrome, encephalopathy, interleukin-6Abstract
The article discusses the burn encephalopathy as a manifestation of organ dysfunction. Purpose: to determine the impact of the systemic inflammatory response to the development of encephalopathy in thermal injury. The study involved 104 patients, who were divided into two groups depending on the severity of the burn injury. The development of SIRS in patients was confirmed by high levels of IL-6 during the whole period of observation. The level of IL-6 did not affect the development, timing and duration of sleep disorders in both groups. The level of LII on the day 1 affects the development of sleep disorders in group 1 (R=0.499, p=0.041). Development of insomnia correlated with the shift of leukocyte formula to the left in group 2 on the day 5 (R=0.349, p=0.020). We found a relationship between the development of delirium, its duration and the level of young forms of neutrophils in patients of 1 (R=0.563, p=0.001) and 2 (R=0.3488, p=0.003) groups. Development of delirium, its timing and duration correlated with the level of IL-6 on day 3 (R=0.812, p=0,049, R=0.5903, p=0.079 and R=0.615, p=0.059, respectively) in the group 2. The extent of the inflammatory reaction determined the disorders of thought (R=-0.545, p=0.036), memory (R=-0.547, p=0.023) and the dynamic of the recovery of cognitive functions in patients of group 1. Cognitive deficit correlated with the level of IL-6 (R=0.760, p=0.079) and the level of young forms of neutrophils (R=-0.603, p=0,013) in group 2. Thus, SIRS is a defining moment in the development of nervous system dysfunction in severe thermal injury.
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