The characteristics of changes in the hemodynamics and respiratory function of children with severe closed abdominal trauma

• Published in: Khirurgiia Vol. 49; no. 3; p. 24
• Main Authors: Tsareva, M, Nedialkova, R
• Format: Journal Article
• Language: Bulgarian
• Published: Bulgaria 1996
• Subjects: Abdominal Injuries - blood; Abdominal Injuries - physiopathology; Abdominal Injuries - surgery; Acute Disease; Adolescent; Carbon Dioxide - blood; Child; Child, Preschool; Hemodynamics; Humans; Infant; Multiple Trauma - blood; Multiple Trauma - physiopathology; Multiple Trauma - surgery; Oxygen - blood; Partial Pressure; Postoperative Period; Respiration; Wounds, Nonpenetrating - blood; Wounds, Nonpenetrating - physiopathology; Wounds, Nonpenetrating - surgery
• ISSN: 0450-2167

Out of 566 children with closed abdominal trauma, treated in the EMI "Pirogov" over a five-year period, 79 present serious impairment of the basic vital functions (respiration, hemodynamics and the like) connected with the trauma and not infrequently with massive blood loss, necessitating the undertaking of resuscitation measures and intensive care. Of the latter 67 are restored to health, and in twelve the outcome is fatal. In terms of hemodynamic parameters a significant tachycardia along with maintaining normal or even increased arterial pressure are the most characteristic, whereas hypotension is present in 6.4 per cent of successfully cured children only on the first day. Regardless of the fact that merely 13.4 per cent of them have direct chest traumas, the gas exchange is considerably disturbed by hypoxemia--in 89 per cent on the first, and in 100 per cent of the children on the third postinjury day; in one-fourth of the cases the hypoxemia is markedly expressed--below 8.0 kPa (60 mm Hg). Along with the decrease in hemoglobin level the latter accounts for pronounced oxygen transport impairment. During the first postinjury day, the acid-base metabolism is characterized by metabolic acidosis development (in 44 per cent of children), with metabolic alkalosis becoming manifest during the next few days. Twelve children presenting severe combined injuries die within several hours of the accident with signs of a serious traumatic-hemorrhagic shock, or within 2-3 days thereafter with evidence of multiple organ failure.