A SYSTEMIC INFLAMMATORY RESPONSE SYNDROME (SIRS) AND ORGAN DYSFUNCTION IN CHILDREN WITH ABDOMINAL TRAUMA

Introduction. To assess SIRS and organ dysfunction in children with abdominal trauma using generally accepted scales is an actual issue for today. Purpose. To verify clinical criteria for SIRS and organ dysfunction in children with abdominal injuries in the perioperative period. Material and methods. 18 patients, aged 6 -12, with injury of their abdominal organs were treated at the Kusch Pediatric Surgery Clinic ( Republican Children’s Clinical Hospital) in Donetsk in 2014-2019. 11 (61.1%) patients with isolated blunt abdominal trauma and injuries of parenchymal organs were taken into Subgroup 1; 7 (38.9%) patients with open abdominal organ trauma and multiple injuries of internal organs - into Subgroup 2. Assessment of mechanical injury severity and prognosis were made using Pediatric Trauma Score (Tepas J.J., 1985) and Revised Trauma Score (Fitzmaurice L.S. 1997). Shock syndrome gradations were made by the FEAST criteria (Fluid Expansion as Supportive therapy) (2017). Results. Nosological configuration of the injury (closed or open, isolated or multiple) as well as the volume and character of surgical intervention were used for defining SIRS severity in children with abdominal injuries. In the perioperative period, parameters characterizing the degree of disorders of vital organs served as unified criteria of organ dysfunction in children with abdominal trauma. Conclusion. Before surgery, the most informative indexes were: tachypnea RR > 18.0 per min, SpO2/FiO2 < 264, HR > 130.0 beats per min, total leukocyte count > 13.5∙109/L or <4.5∙109/L. In the postoperative period: need in the inotropic support of systolic BP within normal limits, invasive / non-invasive mechanical ventilation, oxygen >50% FiO2 to maintain SpO2> 92%, SpO2 / FiO2<264.

systemic inflammatory response, organ dysfunction, children, abdominal trauma