COMPARTMENT SYNDROME IN SEVERELY BURNED PATIENTS AND PROGRESSION TO SEPSIS: NURSING CLINICAL REASONING

Abstract

Patients with severe burns are highly vulnerable to lethal complications, notably Compartment Syndrome (CS) and sepsis. Massive fluid resuscitation can induce "fluid creep" and precipitate compartment hypertension. Tissue ischemia and the loss of body barrier integrity promote bacterial translocation and sepsis. Objective: To determine whether CS in burn patients increases the risk of infectious complications, such as sepsis, and to synthesize the evidence underpinning nursing clinical reasoning regarding the prevention of these complications.Methods: An integrative literature review was conducted using the logical operators "AND" and "OR" and the descriptors Sepsis, Compartment Syndromes, and Burns. The search was performed in the BVS, PubMed, and Embase databases (September–October 2025) following the PRISMA protocol and PICO strategy. Results: Twenty-two articles were included. The incidence of limb CS ranged from 8.3% to 41%, while abdominal compartment syndrome (ACS) affected up to 30% of patients with severe burns. Excessive fluid resuscitation increased the risk of CS, and ACS without early decompression was associated with a mortality rate of up to 100%. Sepsis accounted for 46.1% to 70% of late-stage deaths. Conclusion: CS acts as a primary indicator for sepsis. Intra-abdominal pressure monitoring, fluid balance management, and surveillance for ischemia constitute the pillars of nursing clinical reasoning to ensure patient safety and survival.