UMEM Educational Pearls

This week's pearl is courtesy of Dr. Evie Marcolini.  Thanks Evie!

 

Abdominal Compartment Syndrome in Burn Patients

  • Patients who receive > 250 ml/kg of fluid in the the 24 hours after burn injury will most likely require abdominal decompression.
  • In light of this, bladder pressure monitoring should be part of your practice in resuscitation of the patient with >30% TBSA burns.
  • The simple act of placing the bladder probe will increase awareness of the possibility of ACS and prompt measurement of abdominal compartment pressures. 
  • ACS can be treated with decompressive laparotomy, or in some cases, percutaneous abdominal decompression.

References

Latenser BA.  Critical care of the burn patient: The first 48 hours.  Crit Care Med 2009;37:2819-2826.