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Fredén, Filip
Publications (10 of 19) Show all publications
Fransén, J., Lundin, J., Fredén, F. & Huss, F. (2022). A proof-of-concept study on mortality prediction with machine learning algorithms using burn intensive care data. Scars, Burns & Healing
Open this publication in new window or tab >>A proof-of-concept study on mortality prediction with machine learning algorithms using burn intensive care data
2022 (English)In: Scars, Burns & Healing, ISSN 2059-5131Article in journal (Refereed) Epub ahead of print
Abstract [en]

Introduction

Burn injuries are a common traumatic injury. Large burns have high mortality requiring intensive care and accurate mortality predictions. To assess if machine learning (ML) could improve predictions, ML algorithms were tested and compared with the original and revised Baux score.

Methods

Admission data and mortality outcomes were collected from patients at Uppsala University Hospital Burn Centre from 2002 to 2019. Prognostic variables were selected, ML algorithms trained and predictions assessed by analysis of the area under the receiver operating characteristic curve (AUC). Comparison was made with Baux scores using DeLong test.

Results

A total of 17 prognostic variables were selected from 92 patients. AUCs in leave-one-out cross-validation for a decision tree model, an extreme boosting model, a random forest model, a support-vector machine (SVM) model and a generalised linear regression model (GLM) were 0.83 (95% confidence interval [CI] = 0.72–0.94), 0.92 (95% CI = 0.84–1), 0.92 (95% CI = 0.84–1), 0.92 (95% CI = 0.84–1) and 0.84 (95% CI = 0.74–0.94), respectively. AUCs for the Baux score and revised Baux score were 0.85 (95% CI = 0.75–0.95) and 0.84 (95% CI = 0.74–0.94). No significant differences were observed when comparing ML algorithms with Baux score and revised Baux score. Secondary variable selection was made to analyse model performance.

Conclusion

This proof-of-concept study showed initial credibility in using ML algorithms to predict mortality in burn patients. The sample size was small and future studies are needed with larger sample sizes, further variable selections and prospective testing of the algorithms.

Place, publisher, year, edition, pages
Sage Publications, 2022
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-490045 (URN)10.1177/20595131211066585 (DOI)35198237 (PubMedID)
Available from: 2022-12-07 Created: 2022-12-07 Last updated: 2024-02-20
Holm, S., Engström, O., Melander, M., Horvath, M. C., Fredén, F., Lipcsey, M. & Huss, F. (2022). Cutaneous steam burns and steam inhalation injuries: a literature review and a case presentation. European journal of plastic surgery, 45(6), 881-896
Open this publication in new window or tab >>Cutaneous steam burns and steam inhalation injuries: a literature review and a case presentation
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2022 (English)In: European journal of plastic surgery, ISSN 0930-343X, E-ISSN 1435-0130, Vol. 45, no 6, p. 881-896Article in journal (Refereed) Published
Abstract [en]

Scald is one type of burn that s often mentioned alone and occurs mostly in the paediatric population. Inhaled steam is mostly cooled off in the airways, why thermal damage is rarely seen. A sudden exposure to hot steam/inhalation can cause a thermal inhalation injury. A scoping review was performed, with the aim to summarize all published papers in English, about steam-related injuries. The search was conducted using the PubMed (R) and Cochrane libraries on 19th of May 2021, without a set time period. Out of a total of 1186 identified records, 31 were chosen for review. Burns related to the contact with steam are generally rare and can be both minor and severe. The more severe cases related to steam exposure are mostly workplace accidents and the minor injuries reported in the literature are often related to steam inhalation therapy, especially in the paediatric population. This review describes the challenges that can be found dealing with patients suffering from cutaneous steam burns and/or steam inhalation injuries. A steam injury to the airways or the skin can be directly life-threatening and should be treated with caution. This type of injury can lead to acute respiratory insufficiency and sometimes death. A case of a male patient with extensive cutaneous steam burns and a steam inhalation injury who passed away after 11 days of treatment is also presented to illustrate this review. Level of evidence: Level V, Therapeutic; Risk/Prognostic Study.

Place, publisher, year, edition, pages
Springer Nature, 2022
National Category
Anesthesiology and Intensive Care Surgery
Identifiers
urn:nbn:se:uu:diva-490043 (URN)10.1007/s00238-022-01955-0 (DOI)000790631200002 ()
Funder
Uppsala University
Available from: 2022-12-07 Created: 2022-12-07 Last updated: 2024-02-20Bibliographically approved
Frestadius, A., Grehn, F., Kildal, M., Huss, F. & Fredén, F. (2022). Intranasal dexmedetomidine and rectal ketamine for young children undergoing burn wound procedures. Burns, 48(6), 1445-1451
Open this publication in new window or tab >>Intranasal dexmedetomidine and rectal ketamine for young children undergoing burn wound procedures
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2022 (English)In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 48, no 6, p. 1445-1451Article in journal (Refereed) Published
Abstract [en]

Background: Safe and effective methods for sedation and analgesia in pediatric burn patients are strongly warranted. This retrospective study of electronic health care records aims to evaluate the safety and efficacy of intranasal dexmedetomidine combined with rectal ketamine as procedural sedation for young children undergoing dressing changes and debridement of burn wounds.

Methods: Documentation was analyzed from 90 procedures in 58 pediatric patients aged <5 years. Safety and efficacy of the method were assessed based on documentation for complications, adverse effects, pain level, level of sedation and preoperative and recovery time.

Results: All 90 sedations were completed without significant adverse events with acute airway management or medical intervention. The combination of dexmedetomidine-ketamine produced acceptable analgesia during the procedure and effectively relieved postoperative pain. However, the approach was insufficient for 7/58 patients (7.8%); these patients were converted from the dexmedetomidine-ketamine combination to intravenous anesthesia. In 23% of the cases an extra dose of either ketamine of dexmedetomidine was administered. Moreover, there were two cases of delayed awakening with recovery time >120 min.

Conclusion: The drug combination intranasal dexmedetomidine and rectal ketamine is a safe and reliable approach for procedural sedation and analgesia in pediatric patients undergoing burn wound procedures, producing a clinically stable sedative condition requiring only basic monitoring.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Critical Care and Intensive Care Medicine, Emergency Medicine, General Medicine, Surgery
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-460321 (URN)10.1016/j.burns.2021.08.005 (DOI)000877555700019 ()34895793 (PubMedID)
Available from: 2021-12-06 Created: 2021-12-06 Last updated: 2024-02-20Bibliographically approved
Hultström, M., Hellkvist, O., Covaciu, L., Fredén, F., Frithiof, R., Lipcsey, M., . . . Pellegrini, M. (2022). Limitations of the ARDS criteria during high-flow oxygen or non-invasive ventilation: evidence from critically ill COVID-19 patients. Critical Care, 26, Article ID 55.
Open this publication in new window or tab >>Limitations of the ARDS criteria during high-flow oxygen or non-invasive ventilation: evidence from critically ill COVID-19 patients
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2022 (English)In: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, Vol. 26, article id 55Article in journal (Refereed) Published
Abstract [en]

Background: The ratio of partial pressure of arterial oxygen to inspired oxygen fraction (PaO2/FIO2) during invasive mechanical ventilation (MV) is used as criteria to grade the severity of respiratory failure in acute respiratory distress syndrome (ARDS). During the SARS-CoV2 pandemic, the use of PaO2/FIO2 ratio has been increasingly used in non-invasive respiratory support such as high-flow nasal cannula (HFNC) and non-invasive ventilation (NIV). The grading of hypoxemia in non-invasively ventilated patients is uncertain. The main hypothesis, investigated in this study, was that the PaO2/FIO2 ratio does not change when switching between MV, NIV and HFNC.

Methods: We investigated respiratory function in critically ill patients with COVID-19 included in a single-center prospective observational study of patients admitted to the intensive care unit (ICU) at Uppsala University Hospital in Sweden. In a steady state condition, the PaO2/FIO2 ratio was recorded before and after any change between two of the studied respiratory support techniques (i.e., HFNC, NIV and MV).

Results: A total of 148 patients were included in the present analysis. We find that any change in respiratory support from or to HFNC caused a significant change in PaO2/FIO2 ratio. Changes in respiratory support between NIV and MV did not show consistent change in PaO2/FIO2 ratio. In patients classified as mild to moderate ARDS during MV, the change from HFNC to MV showed a variable increase in PaO2/FIO2 ratio ranging between 52 and 140 mmHg (median of 127 mmHg). This made prediction of ARDS severity during MV from the apparent ARDS grade during HFNC impossible.

Conclusions: HFNC is associated with lower PaO2/FIO2 ratio than either NIV or MV in the same patient, while NIV and MV provided similar PaO2/FIO2 and thus ARDS grade by Berlin definition. The large variation of PaO2/FIO2 ratio indicates that great caution should be used when estimating ARDS grade as a measure of pulmonary damage during HFNC.

Place, publisher, year, edition, pages
Springer NatureSpringer Nature, 2022
Keywords
Acute respiratory distress syndrome, Mechanical ventilation, High-flow oxygen, Non-invasive ventilation
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-470534 (URN)10.1186/s13054-022-03933-1 (DOI)000765759900001 ()35255949 (PubMedID)
Funder
Knut and Alice Wallenberg Foundation, KAW 2020.0182Knut and Alice Wallenberg Foundation, KAW 2020.0241Swedish Heart Lung Foundation, 20210089Swedish Heart Lung Foundation, 20190639Swedish Heart Lung Foundation, 20190637Swedish Heart Lung Foundation, 20200877Swedish Heart Lung Foundation, 20200825Swedish Research Council, 2014-02569Swedish Research Council, 2014-07606Swedish Research Council, 2018-02438Swedish Society for Medical Research (SSMF), 463402221Swedish Society of Medicine, SLS-959793
Available from: 2022-03-29 Created: 2022-03-29 Last updated: 2024-01-15Bibliographically approved
Karlsson, V., Sporre, B., Fredén, F. & Ågren, J. (2022). Randomized controlled trial of low vs high oxygen during neonatal anesthesia: Oxygenation, feasibility, and oxidative stress. Pediatric Anaesthesia, 32(9), 1062-1069
Open this publication in new window or tab >>Randomized controlled trial of low vs high oxygen during neonatal anesthesia: Oxygenation, feasibility, and oxidative stress
2022 (English)In: Pediatric Anaesthesia, ISSN 1155-5645, E-ISSN 1460-9592, Vol. 32, no 9, p. 1062-1069Article in journal (Refereed) Published
Abstract [en]

Background To reduce risk for intermittent hypoxia a high fraction of inspired oxygen is routinely used during anesthesia induction. This differs from the cautious dosing of oxygen during neonatal resuscitation and intensive care and may result in significant hyperoxia. Aim In a randomized controlled trial, we evaluated oxygenation during general anesthesia with a low (23%) vs a high (80% during induction and recovery, and 40% during maintenance) fraction of inspired oxygen, in newborn infants undergoing surgery. Method Thirty-five newborn infants with postconceptional age of 35-44 weeks were included (17 infants in low and 18 in high oxygen group). Oxygenation was monitored by transcutaneous partial pressure of oxygen, pulse oximetry, and cerebral oxygenation. Predefined SpO2 safety targets dictated when to increase inspired oxygen. Results At start of anesthesia, oxygenation was similar in both groups. Throughout anesthesia, the high oxygen group displayed significant hyperoxia with higher (difference-20.3 kPa, 95% confidence interval (CI)-28.4 to 12.2, p < .001) transcutaneous partial pressure of oxygen values than the low oxygen group. While SpO2 in the low oxygen group was lower (difference - 5.8%, 95% CI -9.3 to -2.4, p < .001) during anesthesia, none of the infants spent enough time below SpO(2) safety targets to mandate supplemental oxygen, and cerebral oxygenation was within the normal range and not statistically different between the groups. Analysis of the oxidative stress biomarker urinary F-2-Isoprostane revealed no differences between the low and high oxygen group. Conclusion We conclude that in healthy newborn infants, use of low oxygen during general anesthesia was feasible, while the prevailing practice of using high levels of inspired oxygen resulted in significant hyperoxia. The trade-off between careful dosing of oxygen and risks of hypo- and hyperoxia in neonatal anesthesia should be further examined.

Place, publisher, year, edition, pages
John Wiley & SonsWiley, 2022
Keywords
F2-Isoprostanes, hyperoxia, neonatal anesthesia, oxidative stress, oxygenation
National Category
Pediatrics Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-483581 (URN)10.1111/pan.14519 (DOI)000824216300001 ()35791748 (PubMedID)
Funder
Gillbergska stiftelsen
Available from: 2022-08-31 Created: 2022-08-31 Last updated: 2024-01-15Bibliographically approved
Pellegrini, M., Gudmundsson, M., Bencze, R., Segelsjö, M., Fredén, F., Rylander, C., . . . Perchiazzi, G. (2020). Expiratory Resistances Prevent Expiratory Diaphragm Contraction, Flow Limitation, and Lung Collapse. American Journal of Respiratory and Critical Care Medicine, 201(10), 1218-1229
Open this publication in new window or tab >>Expiratory Resistances Prevent Expiratory Diaphragm Contraction, Flow Limitation, and Lung Collapse
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2020 (English)In: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 201, no 10, p. 1218-1229Article in journal (Refereed) Published
Abstract [en]

Rationale: Tidal expiratory flow limitation (tidal-EFL) is not completely avoidable by applying positive end-expiratory pressure and may cause respiratory and hemodynamic complications in ventilated patients with lungs prone to collapse. During spontaneous breathing, expiratory diaphragmatic contraction counteracts tidal-EFL. We hypothesized that during both spontaneous breathing and controlled mechanical ventilation, external expiratory resistances reduce tidal-EFL.

Objectives: To assess whether external expiratory resistances 1) affect expiratory diaphragmatic contraction during spontaneous breathing, 2) reduce expiratory flow and make lung compartments more homogeneous with more similar expiratory time constants, and 3) reduce tidal atelectasis, preventing hyperinflation.

Methods: Three positive end-expiratory pressure levels and four external expiratory resistances were tested in 10 pigs after lung lavage. We analyzed expiratory diaphragmatic electric activity and respiratory mechanics. On the basis of computed tomography scans, four lung compartments-not inflated (atelectasis), poorly inflated, normally inflated, and hyperinflated-were defined.

Measurements and Main Results: Consequently to additional external expiratory resistances, and mainly in lungs prone to collapse (at low positive end-expiratory pressure), 1) the expiratory transdiaphragmatic pressure decreased during spontaneous breathing by >10%, 2) expiratory flow was reduced and the expiratory time constants became more homogeneous, and 3) the amount of atelectasis at end-expiration decreased from 24% to 16% during spontaneous breathing and from 32% to 18% during controlled mechanical ventilation, without increasing hyperinflation.

Conclusions: The expiratory modulation induced by external expiratory resistances preserves the positive effects of the expiratory brake while minimizing expiratory diaphragmatic contraction. External expiratory resistances optimize lung mechanics and limit tidal-EFL and tidal atelectasis, without increasing hyperinflation.

Place, publisher, year, edition, pages
AMER THORACIC SOC, 2020
Keywords
acute respiratory distress syndrome, artificial respiration, diaphragm, pulmonary atelectasis
National Category
Physiotherapy
Identifiers
urn:nbn:se:uu:diva-413443 (URN)10.1164/rccm.201909-1690OC (DOI)000535260100012 ()32150440 (PubMedID)
Funder
Swedish Heart Lung Foundation, 20170531Swedish Research Council, 2018-02438Swedish Research Council, K2015-99X-22731-01-4
Available from: 2020-06-18 Created: 2020-06-18 Last updated: 2021-10-14Bibliographically approved
Reinius, H., Batista Borges, J., Engström, J., Ahlgren, O., Lennmyr, F., Larsson, A. & Fredén, F. (2019). Optimal PEEP during one-lung ventilation with capnothorax: An experimental study. Acta Anaesthesiologica Scandinavica, 63(2), 222-231
Open this publication in new window or tab >>Optimal PEEP during one-lung ventilation with capnothorax: An experimental study
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2019 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 63, no 2, p. 222-231Article in journal (Refereed) Published
Abstract [en]

Background: One‐lung ventilation (OLV) with induced capnothorax carries the risk of severely impaired ventilation and circulation. Optimal PEEP may mitigate the physiological perturbations during these conditions.

Methods: Right‐sided OLV with capnothorax (16 cm H2O) on the left side was initiated in eight anesthetized, muscle‐relaxed piglets. A recruitment maneuver and a decremental PEEP titration from PEEP 20 cm H2O to zero end‐expiratory pressure (ZEEP) was performed. Regional ventilation and perfusion were studied with electrical impedance tomography and computer tomography of the chest was used. End‐expiratory lung volume and hemodynamics were recorded and.

Results: PaO2 peaked at PEEP 12 cm H2O (49 ± 14 kPa) and decreased to 11 ± 5 kPa at ZEEP (P < 0.001). PaCO2 was 9.5 ± 1.3 kPa at 20 cm H2O PEEP and did not change when PEEP step‐wise was reduced to 12 cm H2O PaCO2. At lower PEEP, PaCO2 increased markedly. The ventilatory driving pressure was lowest at PEEP 14 cm H2O (19.6 ± 5.8 cm H2O) and increased to 38.3 ± 6.1 cm H2O at ZEEP (P < 0.001). When reducing PEEP below 12‐14 cm H2O ventilation shifted from the dependent to the nondependent regions of the ventilated lung (P = 0.003), and perfusion shifted from the ventilated to the nonventilated lung (P = 0.02).

Conclusion: Optimal PEEP was 12‐18 cm H2O and probably relates to capnothorax insufflation pressure. With suboptimal PEEP, ventilation/perfusion mismatch in the ventilated lung and redistribution of blood flow to the nonventilated lung occurred.

Keywords
anesthesia, capnothorax, cardio-thoracic surgery, one lung ventilation, optimal PEEP, PEEP titration
National Category
Anesthesiology and Intensive Care
Research subject
Anaesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-268620 (URN)10.1111/aas.13247 (DOI)000454814700012 ()30132806 (PubMedID)
Funder
Swedish Heart Lung Foundation
Note

Title in thesis list of papers: Optimal PEEP during one lung ventilation with capnothorax. An experimental study

Available from: 2015-12-08 Created: 2015-12-08 Last updated: 2019-01-31Bibliographically approved
Bergquist, M., Hastbacka, J., Glaumann, C., Fredén, F., Huss, F. & Lipcsey, M. (2019). The time-course of the inflammatory response to major burn injury and its relation to organ failure and outcome. Burns, 45(2), 354-363
Open this publication in new window or tab >>The time-course of the inflammatory response to major burn injury and its relation to organ failure and outcome
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2019 (English)In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 45, no 2, p. 354-363Article in journal (Refereed) Published
Abstract [en]

Burn injury causes major inflammatory activation and cytokine release, however, the temporal resolution of the acute and sub-acute inflammatory response has not yet been fully delineated. To this end, we have quantified 20 inflammatory mediators in plasma from 44 adult patients 0-21 days after burn injury and related the time course of these mediators to % total body surface area (TBSA) burned, clinical parameters, organ failure and outcome. Of the cytokines analyzed in these patients, interleukin 6 (IL-6), IL-8, IL-10 and monocyte chemoattractant protein 1 (MCP-1) correlated to the size of the injury at 24-48h after burn injury. In our study, the concentration of IL-10 had prognostic value in patients with burn injury both measured at admission and at 24-48h after injury. However, simple demographic data such as age, % burned TBSA, inhalation injury and their combination, the Baux score and modified Baux score, outperform most of the cytokines, with the exception of IL-8 and MCP1 levels on admission, in predicting death.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD, 2019
Keywords
Cytokines, Burns, Mortality, Multiple organ failure, Severity of illness index
National Category
Anesthesiology and Intensive Care Surgery
Identifiers
urn:nbn:se:uu:diva-380482 (URN)10.1016/j.burns.2018.09.001 (DOI)000461044900012 ()30274808 (PubMedID)
Available from: 2019-04-15 Created: 2019-04-15 Last updated: 2024-02-20Bibliographically approved
Bergquist, M., Huss, F., Fredén, F., Hedenstierna, G., Hästbacka, J., Rockwood, A. L., . . . Bergquist, J. (2016). Altered adrenal and gonadal steroids biosynthesis in patients with burn injury. Clinical Mass Spectrometry, 1, 19-26
Open this publication in new window or tab >>Altered adrenal and gonadal steroids biosynthesis in patients with burn injury
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2016 (English)In: Clinical Mass Spectrometry, ISSN 2213-8005, E-ISSN 2376-9998, Vol. 1, p. 19-26Article in journal (Refereed) Published
Abstract [en]

Introduction: Burn injury inevitably leads to changes in the endogenous production of cytokines, as well as adrenal and gonadal steroids. Previous studies have reported gender-related differences in outcome following burn injury, which suggests that gonadal steroids may play a role. The aim of this study was to assess alterations in concentration of endogenous steroids in patients with burn injury.

Methods: For this single-center, prospective descriptive study, high-sensitivity liquid chromatography tandem mass spectrometry (LC-MS/MS)-based steroid quantification was used to determine longitudinal profiles of the concentrations of endogenous steroids in plasma from sixteen adult male patients with burn injury (14.5-72% of total body surface area). Steroids were extracted from plasma samples and analyzed using multiple reaction monitoring acquisition, with electrospray ionization on a triple quadruple mass spectrometer. Total protein concentration was measured in the samples using spectrophotometry.

Results: Steroid and total protein concentration distributions were compared to reference intervals characteristic of healthy adult men. Concentrations of the following steroids in plasma of burn injured patients were found to correlate positively to the area of the burn injury: cortisol (r = 0.84), corticosterone (r = 0.73), 11-deoxycortisol (r = 0.72), androstenedione (r = 0.72), 17OH-progesterone (r = 0.68), 17OH-pregnenolone (r = 0.64) and pregnenolone (r = 0.77). Concentrations of testosterone decreased during the acute phase and were up to ten-times lower than reference values for healthy adult men, while concentrations of estrone were elevated. By day 21 after injury, testosterone concentrations were increased in younger, but not older, patients. The highest concentrations of estrone were observed on day 3 after the injury and then declined by day 21 to concentrations comparable to those observed on the day of the injury.

Conclusion: Burn injury alters endogenous steroid biosynthesis, with decreased testosterone concentrations and elevated estrone concentrations, during the first 21 days after the injury. Concentrations of glucocorticoids, progestagens and androgen precursors correlated positively with the area of burn injury. The finding of increased estrone following burn injury needs to be confirmed in a larger hypothesis driven study.

Keywords
Burn, Trauma, Gonadal steroids, Sex steroids, Estrogen, Testosterone, DHEA, Androstenedione, LC-MS/MS
National Category
Anesthesiology and Intensive Care Surgery
Identifiers
urn:nbn:se:uu:diva-397419 (URN)10.1016/j.clinms.2016.10.002 (DOI)000510146700004 ()
Funder
Swedish Research Council, 621-2011-4423Swedish Research Council, 2015-4870
Available from: 2019-11-20 Created: 2019-11-20 Last updated: 2024-02-20Bibliographically approved
Bergquist, M., Huss, F., Hästbacka, J., Lindholm, C., Martijn, C., Rylander, C., . . . Fredén, F. (2016). Glucocorticoid receptor expression and binding capacity in patients with burn injury. Acta Anaesthesiologica Scandinavica, 60(2), 213-221
Open this publication in new window or tab >>Glucocorticoid receptor expression and binding capacity in patients with burn injury
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2016 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 60, no 2, p. 213-221Article in journal (Refereed) Published
Abstract [en]

Background

Burn injuries are associated with strong inflammation and risk of secondary sepsis which both may affect the function of the glucocorticoid receptor (GR). The aim of this study was to determine GR expression and binding capacity in leucocytes from patients admitted to a tertiary burn center.

Methods

Blood was sampled from 13 patients on admission and days 7, 14 and 21, and once from 16 healthy subjects. Patients were grouped according to the extent of burn and to any sepsis on day 7. Expression and binding capacity of GR were determined as arbitrary units using flow cytometry.

Results

GR expression and binding capacity were increased compared to healthy subjects in most circulating leucocyte subsets on admission irrespective of burn size. Patients with sepsis on day 7 displayed increased GR expression in T lymphocytes (51.8%, < 0.01) compared to admission. There was a negative correlation between GR binding capacity in neutrophils and burn size after 14 days (< 0.05).

Conclusions

GR expression and binding capacity are increased in most types of circulating leucocytes of severely burned patients on their admission to specialized burn care. If sepsis is present after 1 week, it is associated with higher GR expression in T lymphocytes and NK cells.

National Category
Cell and Molecular Biology
Identifiers
urn:nbn:se:uu:diva-229116 (URN)10.1111/aas.12604 (DOI)000368139700009 ()
Funder
Swedish Research Council, 5315
Available from: 2014-07-31 Created: 2014-07-31 Last updated: 2018-01-11
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