Dr Monali Makadia, Dr Devanshu kalra


Introduction: In severe burns, there is a profound systemic response that persists till the wounds heal. Since these physiological and metabolic
derangements are dynamic over the clinical course of burns, it is expected that both trend of change and absolute values of the proteins, to have a
bearing on the prognosis and the ultimate outcome. Hence, this study evaluates the prognostic value of this metabolic variable in burn patients.
Materials and Methods: The study conducted on 100 adult patients of thermal burn (20% and 60% total body surface area). Serum albumin,
globulin and total proteins were estimated on alternate days starting from day of admission till discharge or death. The 1st-day value and the trend of
serial values throughout the clinical course were compared among expired and survivors. Results: Mean serum values of albumin, globulin, and
total protein on first-day of burns in survivor group were higher. Serum albumin levels of ≤2.1 g/dl at day one was a poor prognostic factor. The
trend in the serum values of albumin, globulin and total protein in survivor group was significantly positive and was negative in expired. Among the
biochemical markers evaluated, most significant prognostic parameter was serum albumin, with maximum sensitivity and specificity. Conclusion:
The cutoff values of proteins and trend of subsequent serial values can guide metabolic manipulations, albumin infusion, and dietary intake. In
addition, these biochemical parameters merit inclusion in burn prognostic index scales. Keywords: Albumin, burns, prognosis, total protein, trends

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