SEVERE CONCURRENT BLUNT ABDOMEN TRAUMA: SPECIFIC FEATURES OF INTENSIVE CARE TACTICS (Report two)

The objective: to work out recommendations on the optimization of intensive care for those with severe concurrent abdomen injuries.

Subjects Specific features of intensive care tactics were analyzed in 210 patients with severe concurrent trauma. The detail characteristics of Groups 1 and 2 are presented in report one on this issue [6]. In order to achieve the objective of the study, the specific course of the trauma disease was analyzed in 54 patients with severe concurrent abdomen trauma.

Results. The difference in the intensive care tactics during the first period of the trauma disease depended on the volume of acute blood loss. In the post-shock period of the trauma disease, the specific parameters in the intensive care in those with a severe abdomen injury, dominating over other injuries, are defined by the infectious complications; the damage control is more often used in them versus patients with the same severity of trauma but without abdomen injury. The main activities of the intensive care of severe sepsis include augmented anti-bacterial therapy, treatment of endotoxicosis and multiple organ failure, use of extracorporeal haemocorrection.

Conclusions. The forecast is the most unfavorable for the period of the maximum probability of complications in the patients with severe concurrent abdomen injury versus those with other severe concurrent injuries. The first period of trauma disease in such patients is characterized by a high volume of infusion-transfusion therapy with a higher frequency of blood reinfusions. In Trauma Center of the first level, the conservative management tactics for not severe injuries of parenchymal abdomen organs seems to be promising for surgery of injuries.

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