Extracorporeal detoxification for septic complications in children during the acute period of severe combined craniocerebral trauma

Abstract

BACKGROUND: The clinical application of extracorporeal detoxification methods in patients with severe concomitant traumatic brain injury has several features and limitations due to intracranial hypertension, traumatic cerebral edema, and the risk of their growth during extracorporeal detoxification. The modern literature presents the results of using extracorporeal detoxification methods in severe concomitant trauma in children. However, practically no data are available on the possibility of their use in severe concomitant craniocerebral trauma, which determines the relevance of research in this direction.

AIM: This study aims to improve the treatment results of affected children with severe concomitant craniocerebral trauma with the addition of septic complications using extracorporeal detoxification methods.

MATERIALS AND METHODS: The experience using extracorporeal detoxification methods, including prolonged veno-venous hemodiafiltration combined with LPS sorption and plasma separation membrane in patient intensive care with severe concomitant craniocerebral trauma complicated by sepsis and septic shock development, is presented.

RESULTS: The use of extracorporeal detoxification methods contributed to eliminating septic shock, stabilization of hemodynamic and internal homeostasis parameters, and regression of multiple organ failure in patients with severe concomitant traumatic brain injury. Monitoring the intracranial pressure and preventing disequilibrium syndrome development enabled avoiding an increase in intracranial hypertension in studied patients.

CONCLUSIONS: Timely and adequate use of extracorporeal detoxification methods improves the clinical course of the acute period of traumatic illness in children with severe concomitant traumatic brain injury. The safe use of efferent therapy methods in patients with severe concomitant traumatic brain injury is ensured by invasive monitoring of intracranial pressure and preventing the development of disequilibrium syndrome.

Keywords

severe concomitant traumatic brain injury in children / extracorporeal detoxification / plasmapheresis / prolonged veno-venous hemofiltration / intracranial hypertension / traumatic cerebral edema

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Novikova T.A., Yeletskaya E.V., Ivanova T.F., Amchislavsky V.G.