INTEGRAL INDEX OF ACID-BASE HOMEOSTASIS AND FORECAST OF STATUS OF CHILDREN IN ACUTE PERIOD OF HEAVY MECHANICAL TRAUMA


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Abstract

Introduction. The management of children in the acute period of severe mechanical trauma (SMT) requires multi-parameter monitoring, a constant assessment of the severity of the condition and the adequacy of intensive care. The abundance of heterogeneous information about the patient determines the need for the development of integrated indices, enabling the rapid assessment of the status and prognosis of the course of the traumatic disease. The assessment of the acid-base state (ABS) of the blood is one of the day-to-day components of multi-parameter monitoring. The aim of the study was to determine the effectiveness and validity of the integral homeostasis index (IHI) obtained on the basis of the results of the ABS testing, for assessing the clinical state, its dynamics and determination the prognosis of the outcome of an acute period of trauma in children. Material and methods. The study included 345 SMT patients. The determination of ABS indices with the automatic calculation of the IHI was routinely performed 2 or more times a day. The obtained values of IHI were expertly compared with the assessment of the severity of the condition and the dynamics of this evaluation in the acute period of the traumatic illness. Results. The study demonstrated 97% accuracy in the determination of the prognosis of the course of the traumatic disease and 93% coincidence with an expert assessment of the severity of the patient’s condition. The results obtained make it possible to recommend the use of IHI for the practical use in the department of anesthesiology and resuscitation under the conditions of a unified information system combining databases (an electronic medical history, a laboratory information system, and a prognostic status and outcome module integrated in the information system and operating in a continuous mode).

About the authors

V. G. Amcheslavskiy

Research Institute of Emergency Pediatric Surgery and Traumatology

Author for correspondence.
Email: vamches@mail.ru
Russian Federation

S. B. Arsenev

Research Institute of Emergency Pediatric Surgery and Traumatology

Email: noemail@neicon.ru
Russian Federation

V. I. Lukyanov

Research Institute of Emergency Pediatric Surgery and Traumatology

Email: noemail@neicon.ru
Russian Federation

K. E. Khmelnitsky

Research Institute of Emergency Pediatric Surgery and Traumatology

Email: noemail@neicon.ru
Russian Federation

E. S. Glebova

Research Institute of Emergency Pediatric Surgery and Traumatology

Email: noemail@neicon.ru
Russian Federation

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