IDENTIFICATION OF PREDISPOSING FACTORS TO MULTIPLE ORGAN DYSFUNCTIONS SYNDROME AMONG BURNED PATIENTS IN INTENSIVE CARE UNIT AT MANSOURA UNIVERSITY
Asmaa Ibrahem Abo Seada - Lecturer of Critical Care Nursing, Faculty of Nursing, Mansoura, University, Egypt
Gehan Abd El-Hakeem Younis - Assistant Professor of Critical Care Nursing, Faculty of Nursing, Tanta University, Egypt
ABSTRACT
Background: Major burn is one of the most severe forms of trauma and usually associated with high morbidity and mortality. Multiple Organs dysfunction syndrome is common in patients with major burns and leading to poor outcomes. Multiple organ dysfunction syndromes are the presence of altered organ function of two or more organ systems in acute ill patients with severe trauma, burn, shock and infection. Patients with burn need critical care units with equipment, supplies and continuously monitoring and life-sustaining organ support until the patients recover and the wounds are healed. Patients with two or more organ systems involved have a mortality rate of approximately 75%, and patients with four organ systems involved have a 100% mortality rate. The skin or deep tissue damage caused by burns, the body’s organs and systems will also experience functional changes or metabolic deterioration accompanied by shock, infection and other complications. However, there are few studies on the prognostic factors of multiple organ injuries after burns. So this study have a chance to identify risk factor of the development organs dysfunction for burned patients Aim of this study was identification predisposing factors to multiple organs dysfunction among burned patients in ICU at Mansoura University. Research questions: Q1: What are the predisposing factors to multiple organs dysfunction among burned patients in ICU? Q2: What is the rate of incidence organ dysfunctions among burned patients occur? Design: A Qualitative exploratory descriptive design was used during the academic year 2018. Sample: fifty patients were selected through purposive sampling technique. Setting: this study was conducted at burned ICU, Mansoura University. Tool of the study: when collect data, two tools used to in this study as follows; demographic & health relevant data, SOFA assessment scale. Results: the current study reveals that mild degree of multiple organ dysfunctions was most noticed among the majority (76%) of the studied sample during the initial assessment (within 24 hours from admission). Also, about two third (66%) and (68%) of studied patients reported moderate multiple organ dysfunction after 24 and 48 hours from admission respectively. Conclusion: the current study can be concluded that, multiple organ(s) dysfunction is a common and serious problem among burned patients and affected (4.0%) of the total admitted ICU patients post 48 hours of admission. Identification of predisposing factors to MODS may lead to better secondary prevention, especially where the most common predisposing factors were shock, infection and cardiac disorders after 48ours. Recommendations: the result of current study can be recommended: Applying of SOFA scores for the assessment of patient with burn and MODS. Designing educational booklets MODS for critical care nurses about predisposing factors, early manifestation, prevention to promote patients’ care.
