Ms Ashlee Kimball1, Dr Edward Gibson1, Mr Darren Molony1, Ms Linda Quinn1, Dr Michelle Lodge1, Dr Amy Jeeves1, Dr Rebecca Cooksey1, Mr Bernard Carney1
1Women’s And Children’s Hospital, North Adelaide, Australia
Major burns are associated with a prothrombotic state. However, it is unclear if major burns in the paediatric population also incur this increased risk. Whilst there are a number of risk factors such as decreased mobilisation, prolonged use of central venous lines and systemic inflammation, these may be overridden by the inherent lower risk of thrombotic events in the paediatric population. This study seeks to examine the incidence of thromboembolic events in major paediatric burns managed at this centre and the risk factors for these events with a view to establishment of guidelines for thromboembolic prevention.
A retrospective audit of all paediatric burns, TBSA ≥30%, managed at the WCH between 1st January 2000 and 31st December 2016 was undertaken. Coding data and the local burns database were used to identify patients and online records and case files were reviewed.
32 cases were identified. 10% of patients experienced thrombotic events. Patients with a thrombus all had a TBSA > 50% and had extended PICU stays. All thrombotic events were associated with central lines. The average time from the burn injury to the clot diagnosis was 42.5 days.
The incidence of thromboembolic events in our population was small but significant and resulted in substantial morbidity. Patients with TBSA > 50% were most commonly affected and central line requirement was a common factor. Whilst further research is required, this study demonstrates that a range of interventions to prevent complications related to venous thrombosis are required in major paediatric burns.
Ashlee is a final year medical student at Flinders University who has a keen interest in the management of burns and plastic surgery