Multiple organ failure in patients with combined breast injury: diagnosis and treatment

Abstract

Relevance. Modern methods of diagnosis and treatment of victims with severe combined trauma, the fulfillment of the conditions of the "golden hour" do not solve the problem of a favorable outcome, sepsis and multiple organ failure (PON) remain the main cause of death.The purpose of the study. To study the possibilities of complex diagnostics and treatment using combined methods of extracorporeal hemocorrection in patients with PON after severe combined breast injury.Object and methods. The results of diagnosis and treatment of 20 victims with combined chest injury were analyzed. The criteria for inclusion in the study were as follows: age over 18 years; severe combined closed chest injury: AIS > 2 on the background of combined injuries, ISS 28–34 points, severity of the condition on the ARASNE II scale over 20 points, the use of extracorporeal hemocorrection (MEG) methods.The results of the study. In patients with severe combined breast injury, the severity of the course of multiple organ failure is shown and the effectiveness of combined methods of extracorporeal hemocorrection (MEG), the features of manifestations of PON and the dynamics of changes in indicators against the background of complex treatment is determined. The main method of diagnosis of PON was a clinical and laboratory picture, taking into account coagulological, biochemical disorders, biomarkers of inflammation and instrumental assessment of CT of the lungs and ultrasound picture of the state of parenchymal organs of the chest and abdomen.Сonclusions. An integrated approach to the management of victims with PON, including early MEG, helps to reduce intoxication, stabilize the condition and increases life expectancy.