ECMO-/ECLS

despite fluid resuscitation. It is particularly useful in younger children who can
develop a relative state of right-sided heart failure after receiving large volumes
of fluid resuscitation.
The benefit of using colloids during the critical phase of burn
resuscitation still remains unanswered. Although several trials have been
performed, none have demonstrated superior long-term outcome with the use
of colloids.
Over the past two decades, there has been an increasing tendency of
using higher resuscitation volumes than those calculated which has the
potential to lead to serious consequences such as abdominal compartment
syndrome (ACS). ACS is defined as impairment in organ function due to
increased abdominal pressures. Approximately, one percent of the general
burn population, will develop ACS, this prevalence increase in patients with a
TBSA > 70%. Although not thoroughly discussed in the pediatric literature,
case reports suggest it happen at any point during resuscitation. Studies have
shown that patients who receive excessive amounts of fluids (250-300 ml/kg)
during the first 24 hours of injury are susceptible to increased abdominal
compartment pressures. One should suspect ACS in patients with unexplained
drops in urine output despite adequate resuscitation or patient with unexplained
increases in peak inspiratory pressures (PIP). The patient can develop a
distended abdoment, hypercarbia, and decreased cardiac output. A simple
way to estimate intra-abdominal compartment pressure is by attaching a
pressure monitor to the patient’s Foley catheter. Many agree that bladder