Case Report: Tachycardia, Hypoxemia and Shock in a Severely Burned Pediatric Patient

Frontiers in Cardiovascular Medicine

article

Jianshe Shi¹  Chuheng Huang¹  Jialong Zheng¹  Yeqing Ai¹  Hiufang Liu¹  Zhiqiang Pan¹  Jiahai Chen¹  Runze Shang²  Xinya Zhang³  Shaoliang Dong³  Rongkai Lin²  Shurun Huang⁴  Jianlong Huang⁵  Chenghua Zhang² 

[1] Department of Surgical Intensive Care Unit, Huaqiao University Affiliated Strait Hospital;Department of General Surgery, Huaqiao University Affiliated Strait Hospital;School of Medicine, Huaqiao University;Department of Burn, Huaqiao University Affiliated Strait Hospital;Key Laboratory of Intelligent Computing and Information Processing, Quanzhou Normal University

关键词: tachycardia;    hypoxemia;    shock;    abdominal compartment syndrome;    pediatric;    severe burns;    continuous renal replacement therapy;   

DOI  :  10.3389/fcvm.2022.904400

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Background Severely burned children are at high risk of secondary intraabdominal hypertension and abdominal compartment syndrome (ACS). ACS is a life-threatening condition with high mortality and requires an effective, minimally invasive treatment to improve the prognosis when the condition is refractory to conventional therapy. Case presentation A 4.5-year-old girl was admitted to our hospital 30 h after a severe burn injury. Her symptoms of burn shock were relieved after fluid resuscitation. However, her bloating was aggravated, and ACS developed on Day 5, manifesting as tachycardia, hypoxemia, shock, and oliguria. Invasive mechanical ventilation, vasopressors, and percutaneous catheter drainage were applied in addition to medical treatments (such as gastrointestinal decompression, diuresis, sedation, and neuromuscular blockade). These treatments did not improve the patient's condition until she received continuous renal replacement therapy. Subsequently, her vital signs and laboratory data improved, which were accompanied by decreased intra-abdominal pressure, and she was discharged after nutrition support, antibiotic therapy, and skin grafting. Conclusion ACS can occur in severely burned children, leading to rapid deterioration of cardiopulmonary function. Patients who fail to respond to conventional medical management should be considered for continuous renal replacement therapy.

【 授权许可】

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