Cardiac compromise in a patient with Down's Syndrome: a lesson learnt.
A 49 year old burn victim with Down's Syndrome (Trisomy 21) was admitted with 15% body surface area (BSA) superficial burns. This was complicated by a large atrioseptal defect. Her course was stormy with difficulties encountered in managing her fluid status. Adequate fluid resuscitation was difficult to maintain with a fragile compromise between pulmonary insufficiency and renal impairment. She expired 12 days post-injury. Cardiac anomalies are not uncommon in the subgroup of patients with major burns who respond poorly to fluid resuscitation.
Lam
D G
DG
Odstock Unit for Burns, Plastic and Maxillo-facial Surgery, Salisbury District Hospital, Wiltshire, UK. lam.david@virgin.net
Pay
A D
AD
Bennett
N J
NJ
Cowburn
P J
PJ
Rossi
A
A
D058186:Acute Kidney Injury / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D002056:Burns / Q000150:complications* / Q000628:therapy; D004314:Down Syndrome / Q000150:complications; D004452:Echocardiography; D017809:Fatal Outcome; D005260:Female; D005440:Fluid Therapy; D006330:Heart Defects, Congenital / Q000150:complications / Q000000981:diagnostic imaging; D006333:Heart Failure / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D018869:Heat-Shock Response; D006801:Humans; D008875:Middle Aged