(1123) High Burden of Ventilator Need in Burn Patients: Is There a Need for More Education?

Introduction: Burn injuries are the cause of over 400,000 emergency department admissions annually. In the United States, these injuries lead to 1 billion in healthcare costs annually. Burn injuries trigger immune and inflammatory responses, metabolic shifts, and distributive shock, which result in multiple organ failure. Consequently, burn care providers face numerous challenges, including acute and critical care management, long-term care, and rehabilitation. A large number of burn patients need mechanical ventilation. This study evaluated the proportion of burn patients who require mechanical ventilation and the overall economic impact.

Methods: Data were extracted from the American Burns Association (ABA) report of five years, 2018 to 2022, from 109 data centers across 39 states and the DC area. Furthermore, ventilator use in burn units and associated costs were analyzed. Our study was limited because data only represents 39 states (not all 50) & 109 burn centers. Inhalation injuries not reported outside of the burn centers are not included. These factors probably cause the under-reporting of ventilator use in burn patients

Results: Each year, one person per 10,000 people requires inpatient hospitalization at a burn unit. There were a total of 152,000 cases over five years. 9,733 cases required ICU admission, using over 100,000 ICU days. Over five years, 1.4 million inpatient days were utilized, with 500,000 days in ICU & 200,000 days on ventilators. The overall mortality rate was around 3.3%. With a conservative estimate, annual spending could be as high as 1 billion USD! 40% of burn patients who needed ICU care go on ventilators, with a mortality rate for cases involving inhalational injuries of 24.9%.

Conclusions: Clinicians need to be aware that the risk of ICU burn patients requiring mechanical ventilation is high, up to 40%. The critical care workforce needs to be educated on the high burden rate of ventilators in the ICU for burn patients. Also, the high mortality rate of almost 25% may call for reevaluating the ventilator management strategy. There may be a need for re-education on inhalation injuries, particularly in the early phase. There is a need to develop strategies to optimize the use of mechanical ventilation in these patients, leading to efficiency and reduced economic burden overall.