КЛИНИЧЕСКАЯ ЭФФЕКТИВНОСТЬ МАССИВНОЙ ТРАНСФУЗИОННОЙ ТЕРАПИИ У ПАЦИЕНТОВ С ПОЛИТРАВМОЙ

Objective – clinical evaluation of the effectiveness of massive infusion-transfusion therapy in patients with polytrauma. Materials and methods . A comparative study of 78 patients with polytrauma. For 42 patients (group 1), a massive infusion-transfusion therapy protocol was used, for 36 (group 2), traditional infusion-transfusion therapy was used. The volume of transfused blood components (erythrocyte suspension, fresh frozen plasma and the volume of infusion of crystalloid solutions in the first three days), the duration of artificial lung ventilation in ICU, the degree of organ dysfunction according to МОDS on the 3rd day, as well as mortality were estimated. Results. In patients of the first group, the volume of transfused blood components was significantly higher. The decrease in blood lactate level on the background of intensive therapy in patients of the 1st group was more pronounced, which allowed normalizing Pv-aCO 2 and ScvO 2 during the first day. The duration of ALV stay in the first group was 2.1 ± 1.8 days, in the second – 7.8 ± 2.4 days. A similar trend was observed with respect to the length of stay of patients in the ICU: 5.4 ± 2.6 days and 9.6 ± 2.1 days. It was established that on the third day the level of up to 4 points on the MODS scale was noted significantly more often in the first group compared to the second – 73.8 % and 50 %. The most pronounced organ dysfunction – from 9 points on the MODS scale to 12 points on the MODS scale – was registered in 4 (11.1 %) victims in the second group and only in 2 (4.8 %) patients in the first group. Fatalities occurred in two (4.76 %) patients in the first group. The victims were rated as 9 and 10 points on the MODS scale. In the second group, 5 (13.88 %) patients died, the severity of injury in which was rated as 8, 9, 10, 10 and 12 points on the MODS scale correspondingly. Conclusion. The implementation of the protocol of massive infusion-transfusion therapy stabilized the patients’ condition, significantly reduced the volume of crystalloid solutions, improved tissue perfusion, prevented the development of abdominal hypertension syndrome, significantly reduced the duration of artificial respiration and the time spent in the ICU, and reduced the hospital mortality.