Intra-abdominal hypertension and abdominal compartment syndrome in burn patients

Background: Intra-abdominal hypertension (IAH) and abdominal compartment sy ndrome (ACS) are known to occur in patients after major abdominal surgery. The incidence of IAH and ACS in the burn population is not known, Methods: We prospectively recorded the intra-abdominal pressures of major b urn patients admitted to our burn center from February 1999 to September 19 99, A bladder pressure greater than 25 mm Hg was diagnosed as IAH. ACS was diagnosed when pulmonary compliance decreased in association with persisten t IAH and was treated with abdominal decompression, Results:Ten patients were placed on the protocol; of these, seven developed IAH, Five responded to conservative treatment. Two patients with 80% body surface area burns developed ACS and required decompression. Conclusions: IAH occurs commonly in major burn patients, and ACS is seen re gularly in patients with more than 70% body surface area burns. We recommen d bladder pressure measurements after infusion of more than 0.25 L/kg durin g the acute resuscitation phase and for peak inspiratory pressures greater than 40 cm H2O. Whereas ACS warrants surgical decompression of the abdomina l cavity, IAH usually responds to conservative therapy.