Tanasiienko P. Infectious complications in patients with polytrauma

Object: patients with multiple injuries in whom the infectious complications of traumatic process developed. Objective: to reduce the lethality of patients with multiple injuries by creating science-proved system of timely diagnosis of infectious complications in patients with multiple injuries and by development and formation of pathogenetic therapeutic measures. Methods: clinical, clinical laboratory, enzyme immunoassay (enzyme immunoassay analyzer "Star Fax 2100" (USA, 2010), immunological (test Brahms PCT-Q, firm Brahms Diag Diagnostica, Berlin, Germany, 2011) and a test system "Мikro LAL-test" of LLC "BioLogika" Russia (2011), microbiological, medical nonparametric statistics. First clinical-epidemiological, clinical and nosological characteristics of infectious complications of traumatic process comprehensively were studied. For the first time the causal factors of infectious complications of traumatic process in patients with multiple injuries were established and analyzed. The features of the response of inflammation markers in patients with infectious complications of multiple injuries were studied. First the character and features of the immune response to trauma by both pro-inflammatory (TNF-?, IL-6, FSC-SP), and anti-inflammatory cytokines (IL-10) were revealed. For the first time on the basis of riskevaluation the method for predicting the occurrence and development of infectious complications of traumatic riskevaluation the method for predicting the occurrence and development of infectious complications of traumatic process was proposed. The modern classification of infectious complications in patients with infectious complications of multiple injuries was offered. The expediency of application of inflammatory markers for the early diagnosis of infectious complications in patients with multiple injuries was proved. The approaches to complex treatment of the infectious complications of traumatic process in patients with multiple injuries clinically were justified. The creation and implementation of the unified system of treatment of infectious complications allows optimizing the process of providing medical aid to the hurt ones with infectious complications after multiple injuries. Developed and implemented a modern clinical and pathogenetic classification of infectious complications in patients with multiple injuries allows organizing the terminology among practicing physicians. The possibility of the using of the laboratory markers of inflammation in patients with multiple trauma was proved. This greatly enhances and accelerates the early diagnosis of infectious complications, improves the efficiency and adequacy of treatment and diagnostic measures in patients with multiple injuries. The results of the dissertation research introduced into clinical practice Kyiv city clinical emergency hospital of Kyiv city council, Vinnitsa city emergency hospital, Vinnitsa regional clinical hospital named Pirogov, Zhitomir central city hospital number 2, Communal number 8 Lviv city hospital, Myronivska CRH of Kiev region, Kalinovskaya CRH of Vinnitsa region, Berdichev CRH of Zhitomir region and in the educational process of the Department of Medicine of catastrophes of the National Medical Academy of Postgraduate Education named Shupyk Ministry of Health of Ukraine. Traumatology and Orthopaedics.