[The diagnosis and correction of impairments of microcirculation, central hemodynamics, and oxygen status in children with traumatic shock].
The paper presents the results of studies of microcirculation, central hemodynamics, and oxygen status in 120 children aged 2-14 years who had traumatic shock of various etiology (40 with burn injury, 50 with mixed injury, and 30 with brain injury). The following studies were used: biomicroscopy of conjunctival microvessels with photo recording and processing on a computer; central hemodynamic monitoring; studies of a thromboelastogram, acid-alkali balance, and blood gases. The authors found the previously unknown parallels of the impairments of microcirculation, the severity of traumatic injury, and the parameters of central hemodynamics, and oxygen status in the patient. Traumatic shock was characterized by spastic impairments of all the components (perivascular, vascular, and intravascular) of microcirculation progressing to spastic-and-atonic ones. The degree of microcirculatory disorders depended on the severity of shock and the nature of injury. The criteria for compensation and decompensation in the microcirculatory module were defined. The routine infusion therapy initiated in the compensation period promotes to a significant alleviation of microcirculatory disorders; however, the mentioned shifts long persist. In this connection, a package of additional measures (infucol GEC solutions, disaggregatory, antihypoxic, and antioxidant agents, and coenzymes of vitamins) has been developed.
Stepanova
N A
NA
Lekmanov
A U
AU
Orbachevskiĭ
L S
LS
D000136:Acid-Base Equilibrium / Q000502:physiology; D000293:Adolescent; D001777:Blood Coagulation / Q000502:physiology; D001784:Blood Gas Analysis; D002648:Child; D002675:Child, Preschool; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008833:Microcirculation / Q000502:physiology; D010100:Oxygen / Q000097:blood*; D012774:Shock, Traumatic / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D015599:Trauma Severity Indices
D010100:Oxygen