Fluid resuscitation management in severely burnt adults at risk of secondary abdominal compartment syndrome - an evidence based systematic review

Abstract

Background: Secondary abdominal compartment syndrome (sACS) in adults with severe burns is commonly unsuspected, can be rapidly fatal and seriously compromises the reliability of urine output as an indicator of perfusion and resuscitation status. Current literature lacks an exhaustive evidence-based review critically appraising all retrieved literature on which clinical decisions may be based. Methods: The evidence on three inter-related concepts was evaluated: fluid-volume management and its contribution to sACS; the role of urinary bladder pressure monitoring; and awareness of the burns community to sACS. Literature published over the last ten years across the major databases was retrieved, and the search strategy was fully reported to reduce the retrieval bias ubiquitous in previous literature. Each article was individually appraised and classified into a framework of evidence, enabling the formulation of specific, graded recommendations.