Sepsis Definitions in Burns.

Affiliation

Meza-Escobar LE(1)(2), Rehou S(1)(3), Jeschke MG(1)(2)(4)(5)(3).
Author information:
(1)Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
(2)Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
(3)Sunnybrook Research Institute, Toronto, Ontario, Canada.
(4)Department of Immunology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
(5)Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Abstract

Background: Sepsis is the leading cause of death in burns. Despite its importance, sepsis lacks a proper definition. An established definition will lead to early and accurate diagnosis, prompt treatment, and a reduced mortality rate. The aim of this work is to discuss current definitions and to look ahead at novel definitions with clinical implications. Method: A review of the current understanding of sepsis definitions in burns. Results: Adaptation of sepsis definitions in the general population and specific burn definitions have gotten better but still need improvements and, potentially, incorporation of molecular, laboratory, patient-specific, and clinical factors. This work includes the history, evolution, and predictive value of current definitions of sepsis in burns. A review of current and future markers of sepsis and potentially useful definitions are presented. Conclusions: Sepsis definitions have evolved over the last decades and will continue to do so. We believe the best definition in burn patients is the Sepsis-3 that was developed originally for critically ill patients. However, there are several studies investigating more specific definitions with better sensitivity and specificity.