الفهرس 
BURN OVERVIEWOnly 14 pages are availabe for public view
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Abstract
Microalbuminuria is thought to be a reflection of increased capillary permeability associated with the systemic inflammatory response syndrome, and has been found to be predictive of outcome in several studies. Therefore, we explored the usefulness of MAU as a predictor of morbidity, and whether there was a correlation between it and outcome in patients with burn injuries.
Microalbuminuria was initially used to predict the onset of chronic renal failure in diabetic patients. Recently, it has shown promise as an early predictor of disease severity in many acute inflammatory conditions. More importantly, it has been found to be predictive of mortality in a heterogeneous group of critically ill patients.
This study was aimed for assessment of micro-albuminuria as an indicator for the post burn systemic inflammatory response syndrome, together with its impact on the prognosis throughout the course of management of burn patients during hospitalization period. Also it was correlated with different events during this time as wound infection, surgical intervention and complications.
Our study was done on a total number of 87 patients (53 males and 34 females) with TBSA less than 50% in the Burn Unit of Ain-Shams University Hospitals and Burn Unit in North West Armed Forces Hospitals. Both sexes and all age groups were included. Pregnant women, renal failure, hypertensive and diabetic patients with positive MAU on admission were excluded. Patients with delay more than 24 hours on admission were also excluded.
The study period was 40 months where MAU had been monitored all over the hospitalization period. Patients were examined daily by an intensivist to document the occurrence of SIRS. Battery of investigations had been routinely performed to monitor the patient’s general condition, development of SIRS and/or MOF and to follow up wound infections. Microalbuminuria was examined in patient’s urine samples collected in early mornings. These investigations were repeated on alternate days regularly till discharge home or death.
Microalbuminuria was found going parallel to the occurrence of SIRS and was positive in moderate and severs degrees of burn, inhalation injury, invasive wound infection, after surgical intervention and in patients with pre-burn comorbidity.
The results we obtained from this study were very variable regarding the behaviour of MAU in individual patients. No regular patterns were found concerning onset, course and disappearance of MAU.
On the basis of our findings, we are unable to declare that microalbuminuria has valuable clinical utility in the initial or delayed phases of burn injury; rather, it simply represents an epiphenomenon. Other alternative markers that would aid as prognostic indicators should be sought, as should potential utility for microalbuminuria during treatment of burn injury.