[Endotoxemia in crush syndrome]

Area of Science:

• Pediatric critical care medicine
• Trauma and emergency medicine
• Immunology and infectious diseases

Background:

• Crush syndrome significantly increases mortality rates in mass catastrophe casualties.
• Pediatric crush syndrome presents unique challenges in treatment and outcomes.
• Endotoxemia is a critical factor contributing to the severity of crush syndrome.

Purpose of the Study:

• To investigate the efficacy of antibody titer (TA) to endotoxin in treating pediatric crush syndrome.
• To evaluate the impact of plasma infusion with naturally increased TA titer on clinical outcomes.
• To assess the role of endotoxemia in the progression of crush syndrome in children.

Main Methods:

• Studied 18 children (aged 9-14) with crush syndrome post-Armenian earthquake.
• Monitored antibody titer (TA) to endotoxin levels.
• Administered complex therapy and compared outcomes between a control group and an experimental group receiving plasma infusion.

Main Results:

• Children's condition worsened with a threefold reduction in TA levels by day 8 in the control group.
• Experimental group receiving plasma infusion showed improved condition the day after infusion.
• Endotoxemia clinical signs persisted for 10-12 days in the control group, versus rapid improvement in the infused group.

Conclusions:

• Plasma infusion with naturally increased antibody titer to endotoxin is a promising therapeutic approach for pediatric crush syndrome.
• Early intervention with TA-rich plasma can mitigate the severity and duration of endotoxemia.
• This treatment strategy offers a potential method to reduce mortality in mass catastrophe victims with crush injuries.