Intra-abdominal Hypertension and Abdominal Compartment Syndrome in Burn Patients

Ivy, Michael E.; Atweh, Nabil; Palmer, John; Possenti, Paul; Pineau, Michael; DʼAiuto, Michael L.

doi:10.1097/00005373-200009000-00001

Cited by 316 publications

(159 citation statements)

References 13 publications

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“…Of these, 22 patients (39%) received greater than 250 mL/kg of volume in the first 24 hours. Based on a previous study by Ivy et al 6 this threshold is associated with increased incidence of ACS. Based on our data there was not a detectible association between this group and the incidence of ACS.…”

Section: Resultsmentioning

confidence: 97%

Joint Theater Trauma System Implementation of Burn Resuscitation Guidelines Improves Outcomes in Severely Burned Military Casualties

Ennis

Chung

Renz

et al. 2008

Journal of Trauma: Injury, Infection &Amp; Critical Care

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Section: Resultsmentioning

confidence: 97%

Joint Theater Trauma System Implementation of Burn Resuscitation Guidelines Improves Outcomes in Severely Burned Military Casualties

Ennis

Chung

Renz

et al. 2008

Journal of Trauma: Injury, Infection &Amp; Critical Care

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“…20,25 In this project, the incidence of ARDS within the first 5 days of admission was 30% in the preimplementation group and was reduced to 10% in the postimplementation group. After review of data, we found that the preimplementation group had more patients with inhalation injuries (47%) than the postimplementation group (38%), which may have contributed to the improved outcomes.…”

Section: Discussionmentioning

confidence: 86%

“…13 Prevention of abdominal compartment syndrome is a primary goal for burn providers, as abdominal compartment syndrome can lead to decreased pulmonary compliance, cardiac dysfunction, multiorgan dysfunction, and/or organ failure. 8 Ivy and colleagues 25 describe a direct relationship between resuscitation volumes delivered per kilogram and the development of abdominal compartment syndrome, validating the importance of wellorchestrated burn resuscitation. Although multiple factors, including mechanism of injury and systemic inflammatory response, affect the patient's risk for secondary complications, overresuscitation exponentially increases the patient's risk.…”

Section: Discussionmentioning

confidence: 92%

“…(Critical Care Nurse. 2013;33[1]: [25][26][27][28][29][30][31][32][33][34][35][36] the nurse to contact the physician for each adjustment in administration of fluids. The change in process was to create a unit-based practice protocol that streamlined the process of burn resuscitation, enabling more efficient and timely fluid adjustments.…”

Section: Implementation Of a Nurse-driven Burn Resuscitation Protocolmentioning

confidence: 99%

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Implementation of a Nurse-Driven Burn Resuscitation Protocol: A Quality Improvement Project

Fahlstrom

Boyle

Makic

2013

Critical Care Nurse

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Background Burn resuscitation, including titration of fluids and administration of colloids, is often driven by physicians’ orders. Inconsistencies in burn resuscitation cause overresuscitation, which has adverse consequences. Methods Retrospective chart reviews were completed to evaluate fluid resuscitation and complications for 12 months before and after development and implementation of a nurse-driven burn resuscitation protocol. Results Before implementation of the protocol, results at 24 hours after injury indicated that 58% of patients were overresuscitated, had a serum level of lactate of at least 2 mmol/L (100%), and had complications (pulmonary edema 20%, abdominal compartment syndrome 7%, acute lung injury/acute respiratory distress syndrome 30%) within the first 5 days. Two outcomes differed from before to after implementation of the protocol: serum level of lactate at 24 hours (t37.8 =2.38, P =.007) and central venous pressure at 48 hours (t31 =2.27, P =.03). After implementation of the protocol, no patients had abdominal compartment syndrome develop. Conclusions Implementation of the nurse-driven burn resuscitation protocol improved nurses’ awareness and assessment of fluid status during resuscitation and improved patients’ outcomes.

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“…The lack of uniformity in definitions for these two entities makes comparisons between different studies difficult [4,5], and has led to a set of proposed definitions [6]. IAH is defined by a sustained or repeated pathological elevation in intraabdominal pressure (IAP) C12 mmHg.…”

Section: Introductionmentioning

confidence: 99%

Validation of the urine column measurement as an estimation of the intra-abdominal pressure

et al. 2009

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Objective: To evaluate the efficacy of the urine column (UC) measurement compared to the intravesicular pressure (IVP) measurement as an estimation of intraabdominal pressure (IAP) in patients with IAP up to 30 mmHg. Methods: Fifteen patients undergoing a laparoscopic cholecystectomy were studied. All patients were catheterized. IVP measurements were performed using a pressure transducer connected to the culture aspiration port. UC measurements were done by holding up the tubing against a measuring rod. The symphysis pubis was used as the zero-reference. IAP was raised from 0 to 30 mmHg using increments of 5 mmHg, during which first the IVP and then UC measurement series were recorded endexpiratory. Fifty and 100 ml of saline were used as a priming volume. Results: The IVP and UC measurements showed a significant correlation with IAP. Comparing IVP and UC showed a correlation of 0.91 (p \ 0.001) for 50 ml and 0.87 (p \ 0.001) for 100 ml of saline as a priming volume. Using 50 ml of saline, UC was 0.68 mmHg higher than IVP (95% CI -7.21 to ?5.85 mmHg). For 100 ml of saline, UC was 1.23 mmHg lower than IVP (95% CI -7.41 to ?9.87 mmHg). Conclusion: UC measurement shows significant correlation to IVP measurement as an estimation of the IAP. Further study needs to be done to conclude whether UC measurement is a reliable clinical alternative to IVP measurement.

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Intra-abdominal Hypertension and Abdominal Compartment Syndrome in Burn Patients

Cited by 316 publications

References 13 publications

Joint Theater Trauma System Implementation of Burn Resuscitation Guidelines Improves Outcomes in Severely Burned Military Casualties

Joint Theater Trauma System Implementation of Burn Resuscitation Guidelines Improves Outcomes in Severely Burned Military Casualties

Implementation of a Nurse-Driven Burn Resuscitation Protocol: A Quality Improvement Project

Validation of the urine column measurement as an estimation of the intra-abdominal pressure

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