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Prevalence of intra-abdominal hypertension and markers for associated complications among severe burn patients: a multicenter prospective cohort study (BURNIAH study)

PURPOSE: Severely 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...

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Autores principales: Strang, Steven G., Breederveld, Roelf S., Cleffken, Berry I., Verhofstad, Michael H. J., Van Waes, Oscar J. F., Van Lieshout, Esther M. M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9001214/
https://www.ncbi.nlm.nih.gov/pubmed/33721051
http://dx.doi.org/10.1007/s00068-021-01623-1
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author Strang, Steven G.
Breederveld, Roelf S.
Cleffken, Berry I.
Verhofstad, Michael H. J.
Van Waes, Oscar J. F.
Van Lieshout, Esther M. M.
author_facet Strang, Steven G.
Breederveld, Roelf S.
Cleffken, Berry I.
Verhofstad, Michael H. J.
Van Waes, Oscar J. F.
Van Lieshout, Esther M. M.
author_sort Strang, Steven G.
collection PubMed
description PURPOSE: Severely 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. METHODS: A 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. RESULTS: Thirty-one (53%) patients developed IAH, 17 (29%) patients developed new organ failure, but no patients developed ACS. Patients had burns of 29% (P(25)–P(75) 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. CONCLUSIONS: The 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 EVIDENCE: Level III, epidemiologic and diagnostic prospective observational study.
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spelling pubmed-90012142022-04-27 Prevalence of intra-abdominal hypertension and markers for associated complications among severe burn patients: a multicenter prospective cohort study (BURNIAH study) Strang, Steven G. Breederveld, Roelf S. Cleffken, Berry I. Verhofstad, Michael H. J. Van Waes, Oscar J. F. Van Lieshout, Esther M. M. Eur J Trauma Emerg Surg Original Article PURPOSE: Severely 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. METHODS: A 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. RESULTS: Thirty-one (53%) patients developed IAH, 17 (29%) patients developed new organ failure, but no patients developed ACS. Patients had burns of 29% (P(25)–P(75) 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. CONCLUSIONS: The 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 EVIDENCE: Level III, epidemiologic and diagnostic prospective observational study. Springer Berlin Heidelberg 2021-03-15 2022 /pmc/articles/PMC9001214/ /pubmed/33721051 http://dx.doi.org/10.1007/s00068-021-01623-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Strang, Steven G.
Breederveld, Roelf S.
Cleffken, Berry I.
Verhofstad, Michael H. J.
Van Waes, Oscar J. F.
Van Lieshout, Esther M. M.
Prevalence of intra-abdominal hypertension and markers for associated complications among severe burn patients: a multicenter prospective cohort study (BURNIAH study)
title Prevalence of intra-abdominal hypertension and markers for associated complications among severe burn patients: a multicenter prospective cohort study (BURNIAH study)
title_full Prevalence of intra-abdominal hypertension and markers for associated complications among severe burn patients: a multicenter prospective cohort study (BURNIAH study)
title_fullStr Prevalence of intra-abdominal hypertension and markers for associated complications among severe burn patients: a multicenter prospective cohort study (BURNIAH study)
title_full_unstemmed Prevalence of intra-abdominal hypertension and markers for associated complications among severe burn patients: a multicenter prospective cohort study (BURNIAH study)
title_short Prevalence of intra-abdominal hypertension and markers for associated complications among severe burn patients: a multicenter prospective cohort study (BURNIAH study)
title_sort prevalence of intra-abdominal hypertension and markers for associated complications among severe burn patients: a multicenter prospective cohort study (burniah study)
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9001214/
https://www.ncbi.nlm.nih.gov/pubmed/33721051
http://dx.doi.org/10.1007/s00068-021-01623-1
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