Document Detail


Orbital compartment syndrome in burn patients.
MedLine Citation:
PMID:  18356713     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To identify clinical characteristics of burn patients requiring emergent orbital decompression for vision-threatening orbital compartment syndrome. METHODS: A retrospective review of 28 burn patients at a trauma center provided data regarding demographics, physical examination findings, and resuscitation fluid volumes. Patients requiring orbital decompression were compared with those who did not, using t tests and Fisher exact test. Linear regression was used to test for an association between peak intraocular pressure and fluid volume. Logistic regression was used to assess associations between need for orbital decompression and fluid volume. RESULTS: Eight of 28 patients required emergent orbital decompression, which immediately reduced intraocular pressure from 59.4 +/- 15.9 mm Hg to 28.6 +/- 8.2 mm Hg (p < 0.001). There was a positive relationship between fluid volume in the first 24 hours and peak intraocular pressure (p < 0.001). Patients who were treated with orbital decompression were resuscitated with a higher fluid volume in the first 24 hours than those who were not (37,218 +/- 14,405 ml versus 24,649 +/- 12,339 ml, p = 0.015). This was no longer statistically significant when adjusted for periocular burns. The relative risk for undergoing orbital decompression in patients receiving > or =8.6 ml/kg/% total body surface area burned in the first 24 hours was 4.4 (p = 0.03). CONCLUSIONS: Risk factors for vision-threatening orbital compartment syndrome include fluid volume and periocular burns. Signs of vision-threatening orbital compartment syndrome should be addressed early with orbital decompression.
Authors:
Christopher N Singh; Matthew B Klein; Stephen R Sullivan; Bryan S Sires; Carolyn M Hutter; Kenneth Rice; Arash Jian-Amadi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ophthalmic plastic and reconstructive surgery     Volume:  24     ISSN:  0740-9303     ISO Abbreviation:  Ophthal Plast Reconstr Surg     Publication Date:    2008 Mar-Apr
Date Detail:
Created Date:  2008-03-21     Completed Date:  2008-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508431     Medline TA:  Ophthal Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  102-6     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology, University of Washington, Seattle, WA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Compartment Syndromes / etiology*,  surgery
Decompression, Surgical
Eye Burns / complications*,  therapy
Female
Fluid Therapy
Humans
Intraocular Pressure*
Male
Middle Aged
Ocular Hypertension / etiology*,  surgery
Orbital Diseases / etiology*,  surgery
Retrospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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