Nutritional and Metabolic Management of Toxidermia Patients Requiring Intensive Care (TEN Metabolism) (TEN metabolism)
Nutritional and Metabolic Characteristics of Critically Ill Patients Admitted for Severe Toxidermia
Retrospective observational cohort study including all patients admitted for toxidermia (Lyell syndrome, Stevens-Johnson Syndrome (SJS), or other extensive skin destruction) to the Burn unit of the adult ICU of the Lausanne burn center between 2006 and 2020.
Inclusion criteria: age >18 years and admission to the burn-ICU for toxidermia whatever body surface affected.
Exclusion criteria: to have declined access to the medical record, a stay shorter than 24 hours, and major burns. The observation period will be limited to the first 31 days of the ICU stay.
All variables related to nutritional and metabolic management will be recorded
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
There are yet no description of the metabolic characteristics of patients admitted for Toxic epidermal necrolysis (TEN) or Stevens-Johnson Syndrome (SJS) which are a rare condition, often assimilated to major burns in terms of metabolic requirements. We will conduct a retrospective observational cohort study including all patients admitted for toxidermia (general term including TEN or Lyell syndrome, SJS, and other extensive skin destruction) to the Burn unit of the adult ICU of the Lausanne burn center between 2006 and 2020. The primary outcome will be compliance with the ICU's feeding protocol (feeding route, early start of enteral feeding, ), and secondary outcomes will include the adequacy of energy and protein delivery, and use of indirect calorimetry, and the comparison with both general and burn critically ill patients from prior studies in the ICU.
Inclusion criteria: age >18 years and admission to the burn-ICU for toxidermia whatever body surface affected.
Exclusion criteria: to have declined access to the medical record, and a stay shorter than 24hours, and major burns. The observation period will be limited to the first 31 days of the ICU stay.
The recorded variables will include demographic characteristics, severity scores (SAPSII, SCORe of Toxic Epidermal Necrosis (SCORTEN for SJS/TEN), Nutrition risk screening (NRS) score), body surface area (BSA) affected by the disease, fluid intakes and balance (exudate volume estimation not included) of the first 10 days, body weight during the stay, renal function, length of mechanical ventilation and of ICU stay. Nutritional variables include the route of feeding, the 24hr energy prescription and delivery, protein, glucose, and lipid intakes, propofol, insulin, indirect calorimetry (IC) studies. Laboratory blood results include glucose, prealbumin, albumin, C-reactive protein (CRP), triglycerides, creatinine, and trace elements (Cu, Se, Zn).
Descriptive statistics: Wilcoxon rank test, while Chi2 test, changes over time with one-way ANOVA .
Study Type
Study Type
Enrollment (Actual)
Enrollment
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- age >18 years
- admission to the burn-ICU
Exclusion Criteria:
- declined access to the medical record
- stay shorter than 24hours
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Compliance with ICU feeding protocol
Time Frame: ICU stay, but maximum 30 days
|
Proportion of ICU days with covered needs
|
ICU stay, but maximum 30 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Protein delivery
Time Frame: ICU stay but maximum 30 days
|
Delivery of at least 1.1 g/kg day of protein
|
ICU stay but maximum 30 days
|
|
Energy delivery
Time Frame: ICU stay but maximum 30 days
|
Delivery of at least 25 kcal/kg/day
|
ICU stay but maximum 30 days
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Eckert Philippe, MD, Université de Lausanne, Director of the ICU
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Chemically-Induced Disorders
- Skin Diseases
- Immune System Diseases
- Stomatognathic Diseases
- Mouth Diseases
- Hypersensitivity
- Erythema
- Skin Diseases, Vesiculobullous
- Dermatitis
- Drug-Related Side Effects and Adverse Reactions
- Stomatitis
- Drug Eruptions
- Erythema Multiforme
- Drug Hypersensitivity
- Stevens-Johnson Syndrome
Other Study ID Numbers
Other Study ID Numbers
- CER-2018-2268
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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