A combined application of extracorporal detoxification techniques in children at the acute stage of severe concomitant traumtic brain injury

Abstract

Introduction. In modern literature, there is a limited information on the techniques of extracorporeal detoxification in children with severe concomitant injuries. Moreover, in fact there are no data on their application in children with severe concomitant traumatic brain injuries. It has defined the relevance of this research.Purpose. To improve outcomes of treatment in children with severe concomitant traumatic brain injuries who have manifestations of toxic-resorptive syndrome (TRS), septic complications, acute renal failure of mixed genesis using a combined application of extracorporeal detoxification techniques.Material and methods. The article describes authors’ experience in a combined application of extracorporeal detoxification techniques, including continuous veno-venous hemodiafiltration (CVVHDF) and membrane plasma separation (MPS) in ICU patients with severe concomitant traumatic brain injuries complicated by toxic-resorptive syndrome, sepsis and septic shock.Results. The combined application of extracorporeal detoxification techniques promoted the regression of toxic-resorptive syndrome, shock reversal, stabilization of hemodynamic parameters, parameters of internal homeostasis as well as the regression of multiple organ failure.Conclusion. Early extracorporeal detoxification improves clinical course at the acute stage of trauma. The authors underline that the key requirement for safety in extracorporeal detoxification in patients with severe concomitant traumatic brain injury is the invasive monitoring of intracranial pressure.