Аnalysis of acute and early periods complications of traumatic disease in severe polytrauma

  • Mariia Matvieienko MD ,assisstant of Department of of Surgical Diseases, Operative Surgery and Topographical Anatomy. V.N. Karazin Kharkiv National University, Kharkiv, Ukraine http://orcid.org/0000-0002-0388-138X
  • Nadegda Baranova MD, PhD, assisstant of Department of Emergency medicine, Anesthesiology and Intensive Care. Kharkiv National Medical University, Kharkiv, Ukraine
  • Serhei Matvieienko MD, Anesthesiologist of the Intensive Care Unit for patients with multiple trauma. KNP " Kharkiv City Clinical Hospital of Emergency", Kharkov, Ukraine
  • Tetiana Kozlova MD, PhD, assisstant professor of Department of General and Clinical Pathology. V.N. Karazin Kharkiv National University, Kharkiv, Ukraine https://orcid.org/0000-0003-0432-6967
  • Alona Gryshchenko MD, assisstant of Department of of Surgical Diseases, Operative Surgery and Topographical Anatomy. V.N. Karazin Kharkiv National University, Kharkiv, Ukraine
  • Arora Sukesh assisstant of Department of of Surgical Diseases, Operative Surgery and Topographical Anatomy. V.N. Karazin Kharkiv National University, Kharkiv, Ukraine
DOI: https://doi.org/10.26565/2313-6693-2019-38-06
Keywords: polytrauma, traumatic disease, complications, acute period, early period

Abstract

Objective of the research is to assess the likelihood of complications in the acute and early periods of Traumatic Disease (TD) and primary condition and reserve capability of hemodynamic and homeostasis in patients with polytrauma. Materials and methods. A retrospective study was carried out on 32 patients suffering from polytrauma. The group of the study included patients with the severity of injury according to the Injury Severity Score (ISS) more than 25 points and on a scale APACHE II 10-25 points at the time of admission.  The estimated blood loss was 30-40% of blood volume (BV). The individual assessment of blood loss was calculated by Moor. Results. The study of 20 (62.5%) men, 12 (37.5%) women aged 18 to 60 years old (35.22 ± 12.66) were done.  The mechanical ventilation was performed for 30 patients (93.75%), and 2 patients (6.25%) required oxygen therapy 5 lit per min for 3 days. The duration of mechanical ventilation was in 10 patients - up to 1 day, 8 patients - up to 3 days and at 12 - more than 3 days. Among 12 patients, who used AMV more than 3 days, 10 patients were tracheostomy in 3d day and 2 patients were extubated on 4th day. Among the patients examined thirty patients (93.7%) had posthemorrhagic anemia during first day of injury. Infectious complications like purulent tracheobronchitis and pneumonia were observed in 14 (43.75%) patients. The local infectious complications (abscesses, festering wounds) occurred in 5 (15.6%) patients and bedsores in 3 (9,375%) patients. The catheterization of the bladder lead to the development of urinary tract infection in 3 patients (9,3%). Conclusion. The most problematic category of victims includes patients with injuries several anatomical regions.  Pneumonia, anemia, urinary tract infection and local infectious complications were considered as the most common complications of acute and early periods TD. The factors that influenced the probability of a high degree of complications were AMV, the thoracic component of the injury, more massive blood loss, long-term catheterization of the bladder.

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Author Biographies

Mariia Matvieienko, MD ,assisstant of Department of of Surgical Diseases, Operative Surgery and Topographical Anatomy. V.N. Karazin Kharkiv National University, Kharkiv, Ukraine

4, Svobody Sq., 61022, Kharkiv, Ukraine

Nadegda Baranova, MD, PhD, assisstant of Department of Emergency medicine, Anesthesiology and Intensive Care. Kharkiv National Medical University, Kharkiv, Ukraine

MD, PhD, assisstant of Department of Emergency medicine, Anesthesiology and Intensive Care.  Kharkiv National Medical University, Kharkiv, Ukraine

Serhei Matvieienko, MD, Anesthesiologist of the Intensive Care Unit for patients with multiple trauma. KNP " Kharkiv City Clinical Hospital of Emergency", Kharkov, Ukraine

61000 Ukraine, Kharkiv, Balakireva Street, 3A

Tetiana Kozlova, MD, PhD, assisstant professor of Department of General and Clinical Pathology. V.N. Karazin Kharkiv National University, Kharkiv, Ukraine

4, Svobody Sq., 61022, Kharkiv, Ukraine

Alona Gryshchenko, MD, assisstant of Department of of Surgical Diseases, Operative Surgery and Topographical Anatomy. V.N. Karazin Kharkiv National University, Kharkiv, Ukraine

4, Svobody Sq., 61022, Kharkiv, Ukraine

Arora Sukesh, assisstant of Department of of Surgical Diseases, Operative Surgery and Topographical Anatomy. V.N. Karazin Kharkiv National University, Kharkiv, Ukraine

4, Svobody Sq., 61022, Kharkiv, Ukraine

References

Kovalenko, V. M., Dorogoi, A. P., Sirenko, Yu. M. (2013). Diseases of the circulatory system in the mortality structure of the population of Ukraine: myths and reality. Materials of the IV National Congress of Cardiologists of Ukraine, 22-29 [in Ukraine].

Medvedovska, Yu. V. (2013). Modern studies of tumors and factors contributing to its growth. Family medicine, №5, 30-34 [in Ukraine].

Blazhenko, A. N., Zavrazhnov, A. A., Dubrov, V. E., Blazhenko, A. A. (2011). Assessment of informativeness of diagnostic methods for combined and multiple injuries in the acute period of polytrauma in a multidisciplinary hospital. Emergency Medical Aid, 12(№4), 68–75 [in Russian].

Skinner, D., Driscoll, P. (2013). ABC of Major Trauma. BMJ Publishing Group – 4th edition. 238.

WHO Library Cataloguing-in-Publication Data World health statistics 2018: monitoring health for the SDGs, sustainable development goals. 2018. 34.

Chepelevska, L. A., Rudnitski, O. P., Dziuba, O. M. (2014). Problems of the Demographic Crisis in Ukraine: A Regional Aspect. Ukraine. The health of the nation, №4(32), 5-9 [in Russian].

Linchevskiy, O. V., Miasnikov, D. V., Makarov, A. V., Hetman, V. H. (2012). Combined trauma: to survive until dawn (problem article). Trauma, 13(№2), 98-102 [in Ukraine].

Nirula, R. (2010 Sep.). Scoop and run to the trauma center or stay and play at the local hospital: hospital transfer's effect on mortality. Trauma. 69(3), 595-599.

Bakke, H. K., Dehli, T., Wisborg, T. (2014). Fatal injury caused by low-energy trauma – a 10-year rural cohort. Acta Anaesthesiologica Scandinavica, № 58(6), 726-732.

Agadzhanyan, V. V., Kravtsov, S. A., Shatalin, A. V., Levchenko, T. V. (2015). Hospital mortality in polytrauma and main directions for its decrease. Polytrauma, №1, 6-15 [in Russian].

Kalinkin, O. G. (2013). Traumatic disease. Trauma, №14, 59-65 [in Russian].

Lozhkin, A. V. (2004). Methods for estimating the volume and degree of blood loss. Bulletin of the blood service of Russia, №4, 39-48 [in Russian].

Pankov, I. O. (2015). Analysis main mortality causes of the patients with severe skeletal polytrauma. Practical medicine, №4-1(89), 157-160.

Prin, M., Li, G. (2016). Complications and in-hospital mortality in trauma patients treated in intensive care units in the United States, 2013. Injury Epidemiology, Vol.3, 18, 1-10.

Khubutia, M. Sh., Shabanov, A. K., Chernenkaya, T. V., Godkov, M. A., Dorfman, A. G. (2011). Infectious Pulmonary Complications in Resuscitation and Intensive Therapy in Victims with Concomitant Injury. General resuscitation, №VII, 4, 24-27 [in Russian].

Schekolova, N. B., Ladeischikov, V. M., Zubareva, N. S. (2016). Early complications of Traumatic Disease with multiple injuries. Perm Medical Journal, XXXIII№3, 25-30 [in Russian].

Ong, A.W., Omert, L.A., Vido, D., Goodman, B.M., Protetch, J., Rodriguez, A., Jeremitsky, E. (2009). Characteristics and outcomes of trauma patients with ICU lengths of stay 30 days and greater: a seven-year retrospective study. Crit Care, №13, R154. https://doi.org/10.1186/cc8054

Published
2019-09-30
How to Cite
Matvieienko, M., Baranova, N., Matvieienko, S., Kozlova, T., Gryshchenko, A., & Sukesh, A. (2019). Аnalysis of acute and early periods complications of traumatic disease in severe polytrauma. The Journal of V. N. Karazin Kharkiv National University, Series "Medicine", (38). https://doi.org/10.26565/2313-6693-2019-38-06
Issue
No. 38 (2019): The Journal of V. N. Karazin Kharkiv National University, series "Medicine"
Section
Clinical research

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