Related Experiment Video
Updated: Sep 5, 2025
How to Administer Near-Infrared Spectroscopy in Critically ill Neonates, Infants, and Children
Published on: August 19, 2020
Case Report: Tachycardia, Hypoxemia and Shock in a Severely Burned Pediatric Patient
Jianshe Shi1, Chuheng Huang1, Jialong Zheng1
1Department of Surgical Intensive Care Unit, Huaqiao University Affiliated Strait Hospital, Quanzhou, China.
Insights
Continuous renal replacement therapy effectively treated abdominal compartment syndrome (ACS) in a severely burned child when conventional methods failed. This intervention improved vital signs and reduced intra-abdominal pressure, offering a new treatment avenue for this critical condition.
Area of Science:
- Pediatric critical care
- Burn management
- Nephrology
Background:
- Severely burned children face high risks of intra-abdominal hypertension and abdominal compartment syndrome (ACS).
- ACS is a life-threatening condition with high mortality, necessitating effective treatments beyond conventional therapies for refractory cases.
Observation:
- A 4.5-year-old girl developed ACS on Day 5 post-severe burn injury, presenting with tachycardia, hypoxemia, shock, and oliguria.
- Standard treatments including mechanical ventilation, vasopressors, and catheter drainage failed to improve her condition.
Findings:
- Continuous renal replacement therapy (CRRT) led to significant improvement in the patient's vital signs and laboratory data.
- CRRT was associated with a decrease in intra-abdominal pressure, resolving the ACS.
Implications:
- Continuous renal replacement therapy is a viable, minimally invasive treatment option for pediatric abdominal compartment syndrome refractory to conventional management.
- Early consideration of CRRT may improve outcomes and reduce mortality in severely burned children with ACS.
Background:
Severely burned children are at high risk of secondary intraabdominal hypertension and abdominal compartment syndrome (ACS). ACS is a life-threatening condition with high mortality and requires an effective, minimally invasive treatment to improve the prognosis when the condition is refractory to conventional therapy.
Case Presentation:
A 4.5-year-old girl was admitted to our hospital 30 h after a severe burn injury. Her symptoms of burn shock were relieved after fluid resuscitation. However, her bloating was aggravated, and ACS developed on Day 5, manifesting as tachycardia, hypoxemia, shock, and oliguria. Invasive mechanical ventilation, vasopressors, and percutaneous catheter drainage were applied in addition to medical treatments (such as gastrointestinal decompression, diuresis, sedation, and neuromuscular blockade). These treatments did not improve the patient's condition until she received continuous renal replacement therapy. Subsequently, her vital signs and laboratory data improved, which were accompanied by decreased intra-abdominal pressure, and she was discharged after nutrition support, antibiotic therapy, and skin grafting.
Conclusion:
ACS can occur in severely burned children, leading to rapid deterioration of cardiopulmonary function. Patients who fail to respond to conventional medical management should be considered for continuous renal replacement therapy.
Related Concept Videos
01:22Burn Injuries
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
01:23Acute Respiratory Failure-IV
01:24Blood Pressure Imbalances and Circulatory Shock
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:30Acute Respiratory Failure-III
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management