Using a Fluid Resuscitation Algorithm to Reduce the Incidence of Abdominal Compartment Syndrome in the Burn Intensive Care Unit.
Background: Patients with large burns must be carefully resuscitated to balance adequate tissue perfusion with the risk of end-organ damage. One devastating complication of overresuscitation is abdominal compartment syndrome. Reducing the volume of fluids given during resuscitation may reduce the in...
| Publicado en: | Critical Care Nurse Vol. 43; no. 6; pp. 58 - 67 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
American Association of Critical-Care Nurses
Dec2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=173949071&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 173949071 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02795442 1GD jtl: Critical Care Nurse issn: 02795442 maglogo: N pubinfo: dt: Dec2023 vid: 43 iid: 6 pid: 2559 pub: American Association of Critical-Care Nurses place: Alisa Veijo, California artinfo: ui: 173949071 173949071 173949071 10.4037/ccn2023162 173949071 ppf: 58 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Using a Fluid Resuscitation Algorithm to Reduce the Incidence of Abdominal Compartment Syndrome in the Burn Intensive Care Unit. aug: au: Peters, Jasmine Won, Paul Herrera, Julie Gillenwater, T. Justin Yenikomshian, Haig A. affil: Jasmine Peters is a plastic surgery resident, University of Wisconsin School of Medicine and Public Health, Division of Plastic and Reconstructive Surgery, Madison sug: subj: Fluid Resuscitation Methods Algorithms Utilization Intra-Abdominal Hypertension Prevention and Control Burn Units Intensive Care Units Human Retrospective Design Prospective Studies Descriptive Statistics T-Tests Mann-Whitney U Test Chi Square Test Comparative Studies Multivariate Analysis Logistic Regression Data Analysis Software Odds Ratio Male Adult Middle Age Adult: 19-44 years Middle Aged: 45-64 years Male ab: Background: Patients with large burns must be carefully resuscitated to balance adequate tissue perfusion with the risk of end-organ damage. One devastating complication of overresuscitation is abdominal compartment syndrome. Reducing the volume of fluids given during resuscitation may reduce the incidence of abdominal compartment syndrome and improve outcomes. Objective: To determine whether decreasing fluid resuscitation volume in a burn center reduced the incidence of abdominal compartment syndrome. Methods: This retrospective cohort study involved all patients with severe burns (total body surface area ≥20%) who were admitted to a burn intensive care unit over 4 years (n = 166). Primary outcomes were required fluid volume, whether differences in the patient characteristics measured affected outcomes, rate of abdominal compartment syndrome, and incidence of abdominal hypertension. After the first 2 years, the Parkland fluid resuscitation algorithm was modified to decrease the volume goal, and patients were assessed for the incidence of abdominal compartment syndrome and related complications such as kidney failure, abdominal hypertension, and ventilator days. Results: A total of 16% of patients resuscitated using the Parkland equation experienced abdominal compartment syndrome compared with 10% of patients resuscitated using the modified algorithm, a difference of 6 percentage points (P =.39). Average volume administered was 11.8 L using the Parkland formula and 9.4 L using the modified algorithm (P =.03). Conclusion: Despite a significant decrease in the amount of fluid administered, no significant difference was found in incidence of abdominal compartment syndrome or urine output. Matched prospective studies are needed to improve resuscitation care for patients with large burns. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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