An Observational Study on Levels of Serum Fibrin Degradation Product (FDP), D-Dimer and Procalcitonin in Burn Sepsis

Abstract

Background: Despite improvements in burn management, infection is still the biggest challenge in major burn cases globally. Burn causes extensive tissue destruction, immune dysfunction, increases the risk of infection and septicemia with high morbidity and mortality. The aim of this study was to observe the levels of serum fibrin degradation product (FDP), D-dimer and procalcitonin in patients with burn sepsis treated in intensive care unit (ICU). Materials & Methods: This observational study was carried out in Department of Burn and Plastic Surgery, Dhaka Medical College Hospital, Dhaka from February 2018 to January 2019. Forty (40) patients with major burns, from (15% to 50% total body surface area burn) with burn sepsis, were recruited for the study. In all cases, plasma level of fibrin degradation product (FDP), D-dimer and procalcitonin were measured and recorded. Result: Male predominance (57.5%) was observed in our study. Eighty five percent (85%) patients had total body surface area burn (TBSA) 20% to 50%. Sixteen patients (40%) suffered from flame burn, 13 (32.5%) patients from scalds and 11 (27.5%) patients had high voltage electric burn. The value of FDP was raised in 62.5% patients, D- dimer in 67.5% patients. Serum procalcitonin level was high (> 2ng/ml), indicating burn sepsis in 47.5% cases but it was not significant (2 sample t – test reveals no significant relationship between rise of serum level of procalcitonin and presence of burn sepsis) Conclusion: Fibrin degradation product (FDP) and D- dimer were raised in two-thirds of burn cases while procalcitonin in two-fifths cases. Measurement of serum level of FDP, Ddimer and procalcitonin may give an idea regarding early onset of bacterial infection and burn sepsis and can serve as an indicator for burn sepsis. J Bangladesh Coll Phys Surg 2023; 41: 193-197