Objective: Severe burns are devastating injuries that result in considerable systemic inflammation and often require\nresuscitation with large volumes of fluid. The result of massive resuscitation is often raised intra-abdominal pressures\nleading to Intra-abdominal hypertension (IAH) and the secondary abdominal compartment syndrome. The objective\nof this study is to conduct (1) a 10 year retrospective study to investigate epidemiological factors contributing to\nburn injuries in Alberta, (2) to characterize fluid management and incidence of IAH and ACS and (3) to review fluid\nresuscitation with a goal to identify optimal strategies for fluid resuscitation.\nDesign: A comprehensive 10-year retrospective review of burn injuries from 1999.\nOutcome Measures: Age, sex, date, mechanism of injury, location of incident, on scene vitals and GCS, type of\ntransport to hospital and routing, ISS, presenting vitals and GCS, diagnoses, procedures, complications, hospital LOS,\nICU LOS, and events surrounding the injury.\nResults: One hundred and seventy five patients (79.4% M, 20.6% F) were identified as having traumatic burn\ninjuries with a mean ISS score of 21.8 (�±8.3). The mean age was 41.6 (�±17.5) (range 14-94) years. Nearly half (49.7%)\nof patients suffered their injuries at home, 17.7% were related to industrial incidents and 14.3% were MVC related.\nOne hundred and ten patients required ICU admission. ICU LOS 18.5 (�±8.8) days. Hospital LOS 38.0 (�±37.8) days. The\nmean extent of burn injury was 31.4 (�±20.9) % TBSA. Nearly half of the patients suffered inhalational injuries (mild\n12.5%, moderate 13.7%, severe 9.1%). Thirty-nine (22.2%) of patients died from their injuries. Routine IAP monitoring\nbegan in September, 2005 with 15 of 28 patients having at least two IAP measurements. The mean IAP was 16.5\n(�±5.7) cm H2O (range: 1-40) with an average of 58 (�±97) IAP measurements per patient. Those patients with IAP\nmonitoring had an average TBSA of 35.0 (�±16.0)%, ISS of 47.5 (�±7.5). The mean 48 hr fluid balance was 25.6 (�±11.1)L\nexceeding predicted Parkland formula estimates by 86 (�±32)%.\nConclusions: Further evaluation of IAP monitoring is needed to further characterize IAP and fluid resuscitation in\npatients with burn injuries.
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