Cardiac compromise in a patient with Down's Syndrome: a lesson learnt

A 49 year old bunt victim with Down's Syndrome (Trisomy 21) was admitted wi th 15% body surface area (BSA) superficial burns. This was complicated by a large atrioseptal defect. Her course was stormy with difficulties encounte red in managing her fluid status. Adequate fluid resuscitation was difficul t to maintain with a fragile compromise between pulmonary insufficiency and renal impairment. She expired 12 days post-injury. Cardiac anomalies are n ot uncommon in the subgroup of patients with major burns who respond poorly to fluid resuscitation. (C) 2000 Elsevier Science Ltd and ISBI. All rights reserved.