A case of multiple organ dysfunction syndrome after large area burns resulting from sustained relatively low heat

摘要

Burn as a strong traumatic stimulus can induce inflammatory responses mediated by neuroendocrine, cytokines and other in-flammatory mediators, and directly lead to organ dysfunction, resulting in severe MODS. Excessive inflammatory responses caused by necrotic tissues in the burned wound, also play an important role in stimulating the occurrence and the development of MODS. Complete removal of necrotic tissues in the early stage of burns to prevent from invasive wound infections, can effec-tively prevent MODS. AKI occurred earlier in this case, combined with its admission after the onset of shock and no obstruction of the urinary system can exclude prerenal and renal AKI, speculated as renal AKI. The factors leading to renal AKI are divided into renal ischemia and nephrotoxicity. The patient had adequate urinary output during shock and AKI in the presence of ad-equate renal blood flow, possibly due to the nephrotoxicity of a large number of necrotic tissues of the wound after they were broken down and absorbed into the bloodstream. The patient fell asleep after being drunk and the bedside stove broiled him for a long time, on one hand, heat accumulation lead to skin damage; on the other hand, sustained heat action caused hyperemia, edema and hemodynamic disorder in the deep tissues, and then resulted in secondary necrosis.