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Published on: June 6, 2011
[FEATURES OF FLUID THERAPY IN CHILDREN WITH SEVERE MAJOR TRAUMA]
Insights
Fluid and transfusion therapy is crucial for treating pediatric severe major trauma. Appropriate administration of crystalloid and colloidal solutions within physiological limits supports positive outcomes and stable hemodynamics in critically injured children.
Area of Science:
- Pediatric critical care medicine
- Trauma resuscitation
- Pediatric emergency medicine
Background:
- Fluid and transfusion therapy are essential for treating children with severe major trauma.
- Effective management significantly influences patient outcomes.
Purpose of the Study:
- To evaluate the effectiveness of fluid and transfusion therapy in pediatric severe major trauma.
- To assess adherence to current clinical recommendations for trauma care in children.
Main Methods:
- A study involving 150 children (0-18 years) with severe major trauma (car and fall injuries).
- Patients were treated in intensive care units across multiple Russian cities.
- Pediatric Trauma Score (PTS) averaged 6.4, with significant ICU stays and mechanical ventilation durations.
Main Results:
- Commonly used crystalloids included Ringer solution, Plasma-lit, and 10% glucose; colloids were Gelofusin and Voluven.
- Blood transfusion was administered to 26% of patients.
- Infusion therapy within the first three days met physiological needs, stabilizing patients without negatively impacting hemodynamics or gas exchange.
Conclusions:
- Well-balanced crystalloid and colloidal solutions, administered within physiological limits, are safe for children with severe combined trauma.
- This therapeutic approach does not adversely affect gas exchange or patient outcomes.
Background:
Fluid and transfusion therapy is proved to be a required component of treating children with severe major trauma significantly influencing the case outcome.
Objective:
To analyze efficiency of fluid and transfusion therapy in children with severe major trauma and assess its correspondence with current recommendations.
Materials And Methods:
150 children aged from 0 to 18 years getting treatment in intensive care units of children's city hospitals of Saint Petersburg, Archangelsk, Ufa, Samara, and Leningrad region were included in the research. The main course of severe major trauma were car injury and catatrauma. The coefficient according to Pediatric trauma score (PTS) was 6.4 points. The mean duration of hospitalization in emergencies units was 3 (2-7) days, the duration of artificial lung ventilation was 48 ± 99.9 hours, the duration of hospitalization in the department ward was 24 (15-32) days. Favorable outcome (transferring from emergencies units to department wards) was reported in 147 (98%) children, death cases were registered in 4 (2.6%) children.
Results:
There was determined that the basic crystalloid solutions used for infusion therapy in children were the following: Ringer solution, Plasma-lit solution and 10% glucose solution. "Gelofisin" and "Voluven" had more frequent administration rate among colloidal solutions. Transfusion of blood was performed in 26% patients. The infusion therapy in the first three days did not exceed the necessary physiological requirements that provided stabilization of the patient's condition and did not produce a negative influence on the status of hemodynamics and gas exchange.
Conclusion:
Administration of current well-balanced crystalloid and colloidal solutions to children with severe combined trauma in an amount within the limits of required physiological indicators does not produce a negative influence on the status of gas exchange and the case outcome.
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