Infusion-transfusion therapy of patients with a syndrome post-traumatic fat embolism
In the paper basic aspects of infusion-transfusion therapy of patients with a syndrome of post-traumatic fat embolism (FES) directed on correction of a number of pathogenetic links of its formation are defined.
The results of clinical and laboratory examination (3rd — 7th day) of 48 patients with injuries of lower extremities and pelvis complicated by subacute form of FES. Studies and analysis of the literature allowed us to determine basic pathogenetic links of FES. Those aspects in addition with the origin and severity of traumatic injuries regulated composition, volume and rate of infusion-transfusion therapy of patients with FES.
Infusion-transfusion therapy was directed to solve such problems as the maintenance of water-electrolytic balance; correction of metabolic disorders and anemia; improvement of blood circulation; providing transport of oxygen and metabolites; detoxification, correction of hypovolemia, hypoxia, and systemic inflammatory response syndrome, which underlie the formation of multiple organ failure in those patients.
The infusion-transfusion therapy involved electrolyte solutions, starches, amino acids, albumin, reamberin, tivortin and polyhydric alcohols. The infusions of glucose solutions, transfusion of blood components and plasma were limited. Fat emulsions were excluded from infusion-transfusion therapy.
The presented program of infusion-transfusion therapy was used in all patients with FES that contributed to the reduction of mortality rate in these patients (from 27.8 % in 2001–2004 to 7.7 % in 2005–2011).
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