Systemic hormonal, electrolyte, andsubstrate changes afternon-thermal limbinjury inchildren

Relatively little isknownregarding the hormonalchangesafterinjuryinchildren.Adultprotocols areoftenapplied to children, although thelatter oftenhave different physiological responsesto trauma.Twentychildren withan angulateddisplaced fracture oftheradius and/or ulna(injury severity score9)were studiedprospectively forchangesin adrenaline, noradrenaline, cortisol, angiotensin II,arginine vasopressin, urea, electrolytes, andglucose. Twobloodsamplesweretaken: oneonarrival attheaccidentandemergencydepartment andone preoperatively several hourslater. There weremarkedincreases inadrenaline, noradrenaline, cortisol, andarginine vasopressinabovethenormalrange.Five (25%)casesdemonstrated greater early increases inadrenaline thanthosereported foradultinjuries ofsimilar severity. Earlyhypokalaemia infourcaseshad corrected towardsnormalwithina few hourswithoutpotassium supplementation. (7Accid Emerg Med1999;16: 104-107)