[Gastro- Intestinal Complications in ICU Burn Patients]

Gastrointestinal (GI) dysfunction in severely burned patients is common and serious. It results in disruption of the mucosal barrier, which is directly implicated in SIRS and enhanced endotoxin absorption and bacterial translocation that leads to MODS and death. We conducted a retrospective descriptive study in an intensive burn care department in Tunisia, over a period of 6 years, in order to evaluate the incidence of GI complications in burn patients and their impact on burn prognosis. A total of 54 patients were included. The mean age of our patients was 40 ± 22.5 years, with a sex-ratio of 1.25/1. In our series, 2 patients had a history of peptic ulcer and only one was on long-term corticosteroids. TBSA was 36.8 ± 16.1% and ABSI was 6.4 ± 2.8. Antiulcer prophylaxis was prescribed in patients with a history of ulcer (n=2). Systemic analgesia during dressing changes was prescribed in 88.9% of cases. The incidence of GI complications was 2.4%. The median delay of occurrence of these complications was 11.5 days. Revealing symptoms were: melena (n=12), hematemesis (n=11), and abdominal distension (n=11). Digestive hemorrhage was the most frequent (59.3%), followed by abdominal compartment syndrome (16.7%) and isolated peptic ulcer (11.1%). Treatment was medical in 87% of cases and surgery was required in 13% of cases. Mortality in our series was 66.7%.