Introduction. Polytrauma (PT) in children is an important medical and social issue because it leads to a high percentage of disability and mortality in pediatric population. Destruction of the muscle mass in patients with PT causes traumatic rhabdomyolysis (TR) in 85% of cases. Such patients develop endogenous intoxication called “toxic-resorbtive state” (TRS) which is caused by the absorption of tissue degradation products into the systemic circulation.Purpose. The aim of the present study was to analyze publications on the diagnostics and treatment of “toxic-resorbtive state”, including extracorporeal techniques.Material and methods. We searched PubMed, Web of Science, Scopus, MEDLINE, eLibrary, and RSCI databases and found about 1800 references and 268 articles. We selected 38 articles for reviewing in traumatology, intensive care and extracorporeal methods.Results. In the acute period of injury, TRS is complicated by the acute kidney injury (AKI) in 5–25% of cases. Mortality in TRS is up to 20%; the leading cause of death is multiple organ failure. TRS markers are myoglobin, creatine phosphokinase lactate, LDH, AST and others. TRS therapy is aimed to prevent and to treat AKI. Continous renal replacement therapy (CRRT) for treating TRS allows to remove myoglobin, CPK and LDH from the circulation and to reduce mortality by half.Conclusion. In TRS management, there are no unified approaches to CRRT indications, regimens, session duration, and choice of optimal filters. In the Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, a trial is planned aiming to assess CRRT effectiveness and safety of TRS treatment in children with polytrauma injuries.

Fever is a defensive and adaptive reaction of the body that develops in response to the action of pathogenic stimuli. It often accompanies various infectious, autoimmune, oncohematological and other diseases. Due to the frequent significant deterioration of children's general health, the occurrence of fever in children gives rise to concern not only in parents, but also in pediatricians. According to temperature level, fever can be classified into different categories: subfebrile - 37.1 to 37.9 °C, moderate -38 to 39 °C, febrile - 39.1 to 41 °C and hyperthermic - above 41 °C. By clinical manifestation distinguish benign, or rose, and malignant, or white, fever. The need to use antipyretic drugs depends not only on the hight of the body temperature elevation, but also on the patient's general health. The clinical guidelines state that the use of acetylsalicylic acid, nimesulide and met-amizole to lower the body temperature in children is not recommended, due to high risk of adverse reactions. Ibuprofen and paracetamol are the drugs of choice to lower body temperature in children both in Russia and abroad. Over 120 comparative studies of these two drug formulations have shown their close efficacy, but ibuprofen is most preferred for the treatment of fever and pain. In order to lower body temperature, parents can uncontrollably use antipyretic drugs in various combinations and incorrect dosages, which leads to severe toxic effects. The article presents a clinical case of Reye's syndrome in a 10-year-old girl, which is most likely associated with the use of aspirin as an antipyretic.