The importance of intra-abdominal pressure measurements in burned children.
Four burned children suffering complications from elevated intra-abdominal pressures prompted initiation of a prospective study to determine the value of intra-abdominal pressure measurements in 30 children with large burns. Intra-abdominal pressures were measured every 4 hours during burn shock or sepsis, or daily during periods of stability. Patients were arbitrarily divided into those having one or more measurements > or = 30 mm Hg or all values < 30 mm Hg. Patients in the > or = 30 mm Hg group had significantly larger burns, higher mortality, and increased instances of sepsis. Five patients had elevated intra-abdominal pressures during burn shock, with two requiring abdominal escharotomies. Seven were at > 30 mm Hg during sepsis, with three requiring paralysis, and one each requiring placement of a peritoneal catheter or laparotomy. Significant intra-abdominal pressure elevations may occur in patients with extensive burns and are associated with a poorer prognosis. Elevation of intra-abdominal pressure should be considered in severely burned patients with oliguria, hypoventilation, or hypotension.
Greenhalgh
D G
DG
Shriners Burns Institute, Cincinnati Unit, Ohio 45229.
Warden
G D
GD
D000005:Abdomen / Q000503:physiopathology*; D002056:Burns / Q000150:complications / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011312:Pressure; D011446:Prospective Studies; D012769:Shock / Q000503:physiopathology