再论腹腔间隙综合征

Reiteration on abdominal compartment syndrome

Since we called for the attention of the occurrence of abdominal compartment syndrome in 2002, forty cases of this complication have been recognized and reported by six burn units in this journal, including three cases accompanied with massive pleural effusion (1601 - 3240 mL). Most cases emerged after "aggressive" fluid resuscitation, especially after massive infusion of crystalloid fluid. The idea "more fluid no harm" should be corrected. The goal of early fluid resuscitation in burn is to correct the hypovolemia and cell hypoxia, and circulating fluid just serves as a carrier in bringing O2 to the cells and carrying out CO2 and other metabolites from tissues. In face of "leaking while infusing", heavy accumulation of fluid in the third spaces may worsen the cell hypoxia. Some of the parameters we get from invasive monitoring systems can be misleading. Now, the trend of overloading should be prevented, and it behaves us to study the regime of lower fluid volume with proper contents in burn shock resuscitation.