Release of abdominal compartment syndrome improves survival in patients with burn injury

Kristina G. Hobson, Kassie M. Young, Amy Ciraulo, Tina L Palmieri, David G Greenhalgh

Research output: Contribution to journalArticle

134 Citations (Scopus)

Abstract

Background: Abdominal compartment syndrome (ACS) has rarely been described as a complication of burn injury. This study describes cases of ACS in patients with burn injury and the physiologic results of abdominal release. Methods: Charts for all patients admitted to two major burn center intensive care units from January 1998 through August 2000 were reviewed for ACS. Physiologic parameters were compared before and after abdominal release. Results: Ten of 1,014 patients developed ACS. Abdominal release improved peak inspiratory pressures and Acute Physiology and Chronic Health Evaluation II scores (p < 0.03). The amount of fluid required to maintain adequate urine output also decreased substantially. Forty percent of patients with ACS survived to discharge. Conclusion: Abdominal release for patients with ACS and severe burn injury results in physiologic improvement and a 40% survival rate. We recommend bladder pressure monitoring for all patients with severe burn injuries and abdominal decompression in any patient who develops pressures greater than 30 mm Hg if they have signs of physiologic compromise. Aggressive expectant management can effect a 40% survival rate in this group of severely injured patients.

Original languageEnglish (US)
Pages (from-to)1129-1133
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume53
Issue number6
StatePublished - Dec 1 2002

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Intra-Abdominal Hypertension
Survival
Wounds and Injuries
Pressure
Survival Rate
Lower Body Negative Pressure
Burn Units
APACHE
Physiologic Monitoring
Intensive Care Units
Urinary Bladder
Urine

Keywords

  • Abdominal compartment release
  • Abdominal compartment syndrome
  • Burns

ASJC Scopus subject areas

  • Surgery

Cite this

Release of abdominal compartment syndrome improves survival in patients with burn injury. / Hobson, Kristina G.; Young, Kassie M.; Ciraulo, Amy; Palmieri, Tina L; Greenhalgh, David G.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 53, No. 6, 01.12.2002, p. 1129-1133.

Research output: Contribution to journalArticle

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N2 - Background: Abdominal compartment syndrome (ACS) has rarely been described as a complication of burn injury. This study describes cases of ACS in patients with burn injury and the physiologic results of abdominal release. Methods: Charts for all patients admitted to two major burn center intensive care units from January 1998 through August 2000 were reviewed for ACS. Physiologic parameters were compared before and after abdominal release. Results: Ten of 1,014 patients developed ACS. Abdominal release improved peak inspiratory pressures and Acute Physiology and Chronic Health Evaluation II scores (p < 0.03). The amount of fluid required to maintain adequate urine output also decreased substantially. Forty percent of patients with ACS survived to discharge. Conclusion: Abdominal release for patients with ACS and severe burn injury results in physiologic improvement and a 40% survival rate. We recommend bladder pressure monitoring for all patients with severe burn injuries and abdominal decompression in any patient who develops pressures greater than 30 mm Hg if they have signs of physiologic compromise. Aggressive expectant management can effect a 40% survival rate in this group of severely injured patients.

AB - Background: Abdominal compartment syndrome (ACS) has rarely been described as a complication of burn injury. This study describes cases of ACS in patients with burn injury and the physiologic results of abdominal release. Methods: Charts for all patients admitted to two major burn center intensive care units from January 1998 through August 2000 were reviewed for ACS. Physiologic parameters were compared before and after abdominal release. Results: Ten of 1,014 patients developed ACS. Abdominal release improved peak inspiratory pressures and Acute Physiology and Chronic Health Evaluation II scores (p < 0.03). The amount of fluid required to maintain adequate urine output also decreased substantially. Forty percent of patients with ACS survived to discharge. Conclusion: Abdominal release for patients with ACS and severe burn injury results in physiologic improvement and a 40% survival rate. We recommend bladder pressure monitoring for all patients with severe burn injuries and abdominal decompression in any patient who develops pressures greater than 30 mm Hg if they have signs of physiologic compromise. Aggressive expectant management can effect a 40% survival rate in this group of severely injured patients.

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