Abstract
Background. Massive blood loss is one of the main causes of deaths and complications both in patients requiring extensive surgical interventions and those with severe trauma.Aim. To analyse available publications devoted to the definition, pathogenesis, diagnosis and intensive care of acute massive blood loss in children.Materials and methods. The conducted analysis involved 102 publications by Russian and foreign authors from the PubMed database devoted to the problem of massive blood loss in children.General findings. The paper presents modern definitions of massive blood loss in children. Special attention is paid to the pathogenesis, diagnosis and treatment of massive blood loss in severe trauma cases. The principles of correcting the deficiency of circulating blood volume, the use of inotropic and vasopressor drugs, as well as the elimination of severe anemia and hemostasis disorders, are considered. Publications devoted to the search for an optimal ratio of globular and plasma volumes during the transfusion of blood components are reviewed. It is shown that the reviewed publications report conflicting opinions regarding the use of antifibrinolytic medications. At the same time, the high efficiency of tranexamic acid and its positive effect on the functional outcome in patients with severe trauma is demonstrated. In order to optimize approaches to the management of massive blood loss in children, additional multicenter studies are required. These studies should consider the effect of the underlying disease that caused massive blood loss, as well as the treatment and diagnostic capacity of hospitals.
Highlights
Massive blood loss is one of the main causes of deaths and complications both in patients requiring extensive surgical interventions and those with severe trauma
To analyse available publications devoted to the definition, pathogenesis, diagnosis and intensive care of acute massive blood loss in children
The conducted analysis involved 102 publications by Russian and foreign authors from the PubMed database devoted to the problem of massive blood loss in children
Summary
Массивная кровопотеря является одной из основных причин летальных исходов и осложнений как у больных, нуждающихся в обширных хирургических вмешательствах, так и у пострадавших с тяжелой травмой. Цель — анализ публикаций, посвященных определению, патогенезу, диагностике и интенсивной терапии острой массивной кровопотери у детей. Представлены современные определения массивной кровопотери у детей, особенности патогенеза, диагностики и лечения массивной кровопотери при тяжелой травме. Продемонстрирована противоречивость и неоднозначность мнений в отношении применения антифибринолитических препаратов, отражены высокая эффективность использования транексамовой кислоты и ее положительное влияние на функциональный исход у больных с тяжелой травмой. Для оптимизации интенсивной терапии массивной кровопотери у детей необходимо проведение дальнейших мультицентровых исследований в зависимости от основного заболевания, ставшего причиной развития массивной кровопотери, и лечебно-диагностических возможностей стационара, где находится ребенок.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.