Skip to main content

Intraabdominal pressure in critical burn patients

Introduction

The aim was to study the evolution and incidence of intraabdominal hypertension in critical burn patients using a slightly restrictive fluid therapy protocol based on monitoring transpulmonary thermodilution and lactic acid.

Methods

A prospective study of 132 consecutive patients admitted to the Critical Burn Unit between October 2008 and October 2011. In all of them resuscitation was performed by objectives: blood pressure (>65 mmHg), hourly diuresis (0.5 to 1 cm3/kg), lactic acid clearance and thermodilution transpulmonary parameters (CI >2.5 l/minute/m2, ITBI: 600 ml/m2). We performed measurements of IAP with a bladder catheter every 8 hours in the first 72 hours.

Results

Ninety-eight men and 34 women were studied. Mean age 48 ± 18 years and a TBSA of 35 ± 22%. The fluid provided by %TBSA in the first 8 hours was less than predicted by Parkland (4.05 ml/kg), although the total contribution in the first 24 hours was similar. The evolution of the intra-abdominal pressure was: admission 9.7 mmHg, 8 hours 11, 16 hours 10.5, 24 hours 12.1, 32 hours 12.0, 40 hours 12.0, 48 hours 11.1, 56 hours 10.3, 64 hours 10.0 and 72 hours 10.0. A total of 44 patients (33.3%) had a determination higher than 12 mmHg, distributed: 15 patients between 12 and 15 mmHg (IAHT I grade), 14 between 16 and 20 mmHg (II), nine between 21 and 25 mmHg (III) and six >25 mmHg (IV). See Figures 1 and 2.

Figure 1
figure1

Intraabdominal pressure.

Figure 2
figure2

IAH classification.

Conclusion

IAH incidence when a slightly restrictive fluid protocol used is less than expected.

Author information

Affiliations

Authors

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Millan, P. Intraabdominal pressure in critical burn patients. Crit Care 19, P386 (2015). https://doi.org/10.1186/cc14466

Download citation

Keywords

  • Blood Pressure
  • Hypertension
  • Catheter
  • Lactic Acid
  • Emergency Medicine