The role of diagnosis of respiratory dysfunction in patients with thoracic trauma with polytrauma
Annotation. Combined thoracic trauma is one of the most unfavorable in determining the prognosis in patients with polytrauma. The aim of the study was to evaluate the informativeness of the spirography method in patients with concomitant thoracic trauma as a prognostic criterion for the severity of the course of traumatic disease and the effect of the proposed modifications of the intensive care algorithm on treatment results. A study of the state of indicators of the function of external respiration was carried out using the method of spirography in 92 patients with concomitant thoracic trauma. The patients were divided into 3 groups depending on the foreseen leading pathogenetic mechanism of respiratory failure in all periods of traumatic illness. The effect of additional administration of ceruloplasmin solution, solution of D-fructose-1,6-diphosphate sodium salt hydrate solution was compared with the classical algorithm of intensive therapy. The effect of the proposed treatment was assessed 30 days after receiving polytrauma and the parameters of the external respiration function were compared with the data obtained in conditionally healthy volunteers. It was determined that the addition of a solution of ceruloplasmin to the algorithm of intensive therapy, the leading mechanism of action of which is the effect on oxidative stress, is the most pathogenetically determined in patients with concomitant thoracic trauma in polytrauma, which is confirmed by the most restored indicators of the function of external respiration in them, determined using spirography on the 30th day of observation. The data obtained are important in determining the prognosis of the course of traumatic illness and planning a rehabilitation program in patients with concomitant thoracic trauma.
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