• François Dépret, Chloé Dunyach, Christian De Tymowski, Maïté Chaussard, Aurélien Bataille, Axelle Ferry, Nabila Moreno, Alexandru Cupaciu, Sabri Soussi, Mourad Benyamina, Alexandre Mebazaa, Kevin Serror, Marc Chaouat, Jean-Pierre Garnier, Romain Pirracchio, Matthieu Legrand, and PRONOBURN group.
• Department of Anesthesiology and Critical Care and Burn Unit, Groupe Hospitalier St-Louis-Lariboisière, Assistance publique - Hôpitaux de Paris, Paris, France.
• Crit Care. 2017 Sep 26; 21 (1): 245.

BackgroundIntravascular haemolysis has been associated with acute kidney injury (AKI) in different clinical settings (cardiac surgery, sickle cell disease). Haemolysis occurs frequently in critically ill burn patients. The aim of this study was to assess the predictive value of haptoglobin at admission to predict major adverse kidney events (MAKE) and AKI in critically ill burn patients.MethodsWe conducted a retrospective, single-centre cohort study in a burn critical care unit in a tertiary centre, including all consecutive severely burned patients (total burned body surface > 20% and/or shock and/or mechanical ventilation at admission) from January 2012 to April 2017 with a plasmatic haptoglobin dosage at admission.ResultsA total of 130 patients were included in the analysis. Their mean age was 49 (34-62) years, their median total body surface area burned was 29% (15-51%) and the intensive care unit (ICU) mortality was 25%. Early haemolysis was defined as an undetectable plasmatic haptoglobin at admission. We used logistic regression to identify MAKE and AKI risk factors. In multivariate analysis, undetectable haptoglobin was associated with MAKE and AKI (respectively, OR 6.33, 95% CI 2.34-16.45, p < 0.001; OR 8.32, 95% CI 2.86-26.40, p < 0.001).ConclusionsUndetectable plasmatic haptoglobin at ICU admission is an independent risk factor for MAKE and AKI in critically ill burn patients. This study provides a rationale for biomarker-guided therapy using haptoglobin in critically ill burn patients.

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