[Reiteration on abdominal compartment syndrome]
1Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, Third Military Medical University, Chongqing 400038, PR China.
Summary
Aggressive fluid resuscitation in burn patients can lead to abdominal compartment syndrome and worsen cell hypoxia. Lower fluid volumes with proper contents are recommended for burn shock resuscitation to prevent fluid overload.
Area of Science:
- Critical Care Medicine
- Trauma Surgery
- Burn Management
Context:
- Abdominal compartment syndrome (ACS) is a recognized complication in burn patients.
- Forty cases of ACS reported by six burn units, including three with massive pleural effusion (1601-3240 mL).
- Most ACS cases followed aggressive fluid resuscitation, particularly massive crystalloid infusion.
Purpose:
- To re-evaluate the "more fluid no harm" concept in burn resuscitation.
- To highlight the risks of fluid overload and potential worsening of cell hypoxia.
- To advocate for a shift towards lower fluid volumes with appropriate content in burn shock management.
Summary:
- Fluid resuscitation in burns aims to correct hypovolemia and cell hypoxia.
- Excessive fluid accumulation in "third spaces" can exacerbate cell hypoxia.
- Invasive monitoring parameters may be misleading; fluid overloading must be prevented.
Impact:
- Challenges the traditional "more fluid no harm" approach in burn care.
- Emphasizes the need to prevent fluid overloading in burn shock resuscitation.
- Suggests exploring lower fluid volume resuscitation strategies with optimized fluid content.
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