832 Continuous Real-Time IAP Monitoring in Severe Burns: A Case Study

TL;DR

This case study shows how continuous intra-abdominal pressure monitoring helped prevent a serious complication in a severe burn patient.

Contribution

The study demonstrates the clinical value of real-time IAP monitoring in managing severe burns.

Findings

Continuous IAP monitoring detected a critical pressure spike in a burn patient on day two.

Timely intervention reduced IAP to safe levels without invasive procedures.

The case suggests continuous monitoring could become a new standard in severe burn care.

Abstract

Managing severe burns often necessitates aggressive fluid resuscitation, which can lead to complications like intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Traditional intermittent intra-abdominal pressure (IAP) monitoring may not always capture critical pressure changes, underscoring the need for continuous monitoring in high-risk patients.

We present the case of a 28-year-old male with 49% total body surface area burns, treated with Parkland formula-guided fluid resuscitation and early surgical debridement. Continuous IAP monitoring was implemented using a specialized urethral catheter with an electronic transducer. IAP levels were tracked in real-time alongside mean arterial and abdominal perfusion pressure.

On the second day post-admission, IAP spiked to 20 mmHg, signaling an increased risk of ACS. Immediate intervention reduced the IAP to under 10 mmHg within 24 hours, effectively preventing ACS without requiring invasive procedures.

This case highlights the potential of continuous IAP monitoring as a valuable tool in severe burn management. Early detection of IAH allowed for timely intervention, reducing the likelihood of ACS and potentially lowering patient morbidity. Continuous monitoring may suggest a new standard of care in high-risk burn patients, although further research with larger cohorts is necessary to validate these findings.

Continuous IAP monitoring shows promise in improving outcomes for high-risk burn patients, offering a non-invasive early detection and intervention method.

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