Final answer:
The leading complication of severe burns in the first week even with adequate initial fluid resuscitation is infection, which can cause disseminated intravascular coagulation, circulatory shock, and potentially lead to multi-organ failure and death.
Step-by-step explanation:
Complication of Severe Burns with Initial Fluid Resuscitation
The leading complication of severe burns in the first week despite adequate initial fluid resuscitation is infection. When the skin suffers a severe burn, its protective barrier is compromised, making it highly susceptible to bacteria and other pathogens. Managing the risk of infection becomes a primary concern, especially after the initial fluid resuscitation has been addressed. Infection can lead to various dangerous complications, including fever, hypotension, disseminated intravascular coagulation (DIC), and circulatory shock, potentially resulting in organ failure such as renal and hepatic failure, and in severe cases, death.
Initial treatment of severe burns includes the administration of intravenous fluids to combat dehydration and maintain circulation. This treatment helps prevent hypovolemic shock. However, once stabilization is achieved, the risk of infection takes precedence, and broad-spectrum antibiotics are often employed as a preventive measure. Despite antibiotic therapy, infection can still occur and result in rapid clinical deterioration, as evidenced by rapidly spreading necrosis, edema, changes in wound coloration, and systemic effects such as shock and multi-organ failure.