title: [Clinical effectiveness of the infusion therapy under control of the transesophageal dopplerography in acute period of severe combined trauma].
abstract: In 72 patients with combined trauma the impact of volume and consistence of infusion therapy on severity of the disease, frequency and severity of infectious complications, duration of MV and ICU stay was assessed. The patients were divided into 2 groups depending on the volemic status control method and infusion algorithm. The main group (35 patients) was controlled by transesophageal dopplerography Cardio Q apparatus ("Deltex Medical", GB) and the infusion therapy was carried out under the control of stroke volume and Ftc. In the control group (37 patients) the volemic status was assessed clinically: BP, CVP, HR, diuresis. The volume of the infusion therapy during the first 12 hours in the main group was significantly higher than in the control group which proved that patients were suffering from hypovolemia, which was not diagnosed by traditional clinical criteria. The ICU stay in the main group was significantly shorter compared to the control group 15.3 +/- 8.2 and 29.5 +/- 10.4 days respectively. Infectious complications occurred in 12 patients out of 35 in main group and 25 out of 37 in the control group. The conclusion of this study is that infusion therapy control with central hemodynamic parameters can shorten the MV time and ICU stay an lower the rate of infectious complications in patients with combined trauma. A mortality decrease in patients with transesophageal dopplerography controlled infusion is not shown.
authors.forename: K E
authors.initials: KE
authors.lastname: Vil'chinskiĭ
authors.forename: A I
authors.initials: AI
authors.lastname: Gutnikov
authors.forename: L A
authors.initials: LA
authors.lastname: Davydova
authors.forename: S V
authors.initials: SV
authors.lastname: Tsarenko
authors.forename: E A
authors.initials: EA
authors.lastname: Evdokimov
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001810:Blood Volume / Q000502:physiology; D001811:Blood Volume Determination / Q000295:instrumentation / Q000379:methods; D000077324:Crystalloid Solutions; D017548:Echocardiography, Transesophageal; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage; D020896:Hypovolemia / Q000209:etiology / Q000517:prevention & control; D007552:Isotonic Solutions / Q000008:administration & dosage; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D010952:Plasma Substitutes / Q000008:administration & dosage; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D055815:Young Adult
chemical_list: D000077324:Crystalloid Solutions; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes