Abstract
PurposeSeverely burned patients are at risk for intra-abdominal hypertension (IAH) and associated complications such as organ failure, abdominal compartment syndrome (ACS), and death. The aim of this study was to determine the prevalence of IAH among severely burned patients. The secondary aim was to determine the value of urinary intestinal fatty acid binding protein (I-FABP) as early marker for IAH-associated complications.MethodsA prospective observational study was performed in two burn centers in the Netherlands. Fifty-eight patients with burn injuries ≥ 15% of total body surface area (TBSA) were included. Intra-abdominal pressure (IAP) and urinary I-FABP, measured every 6 h during 72 h. Prevalence of IAH, new organ failure and ACS, and the value of urinary intestinal fatty acid binding protein (I-FABP) as early marker for IAH-associated complications were determined.ResultsThirty-one (53%) patients developed IAH, 17 (29%) patients developed new organ failure, but no patients developed ACS. Patients had burns of 29% (P25–P75 19–42%) TBSA. Ln-transformed levels of urinary I-FABP and IAP were inversely correlated with an estimate of − 0.06 (95% CI − 0.10 to − 0.02; p = 0.002). Maximal urinary I-FABP levels had a fair discriminatory ability for patients with IAH with an area under the ROC curve of 74% (p = 0.001). Urinary I-FABP levels had no predictive value for IAH or new organ failure in severe burn patients.ConclusionsThe prevalence of IAH among patients with ≥ 15% TBSA burned was 53%. None of the patients developed ACS. A relevant diagnostic or predictive value of I-FABP levels in identifying patients at risk for IAH-related complications, could not be demonstrated.Level of evidenceLevel III, epidemiologic and diagnostic prospective observational study.
Highlights
Patients with severe burns are at risk for complications and sequelae resulting in morbidity and death with increasing burn severity
Intra-abdominal hypertension (IAH) and subsequent abdominal compartment syndrome (ACS) are complications in severely burned patients associated with poor outcome
Patients had a median age of 48 years (30–58 years), a median Acute Physiology and Chronic Health Evaluation (APACHE) II score of 11 (8–17) and a median burned total body surface area (TBSA) of 29% (P25–P75 19–42%, deep dermal and full thickness)
Summary
Patients with severe burns are at risk for complications and sequelae resulting in morbidity and death with increasing burn severity. Intra-abdominal hypertension (IAH) and subsequent abdominal compartment syndrome (ACS) are complications in severely burned patients associated with poor outcome. ACS-associated mortality among severe burn patients is estimated at 74.8% [1]. These complications result from the combination of capillary leakage, fluid shifts and hypotension requiring extensive fluid suppletion [2]. The effect of fluid shift is called “third spacing” referring to an extra space to where the fluid shifts to. This space or compartment frequently concerns the abdomen.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
