Publication detail

Farmakologická blokáda SIRS u závažných poranění hrudníku.

Year: 2003

Type of publication: článek v odborném periodiku

Name of source: Rozhledy v chirurgii

Publisher name: Česká lékařská společnost JEP, Sokolská 31, Praha

Place: Praha

Page from-to: 473-479

Titles:

Language	Name	Abstract	Keywords
cze	Farmakologická blokáda SIRS u závažných poranění hrudníku.	Farmakologická blokáda SIRS	Farmakologická blokáda SIRS, hrudník
eng	Pharmacological blockade of the SIRS in serious chest injuries	Introduction: Frequency and severity of the blunt chest injuries are increasing. Rather high letality is caused by the injury and following systemic inflammatory response. Objective: The aim of the study is to verify the efficacy of pharmacological blockade of the systemic inflammatory response syndrome (SIRS) in serious blunt chest injuries. The aim is also to find out if the administration of indomethacin as a cyclooxygenase inhibitor could prevent multiorgan dysfunction (MODS) and multiorgan failure (MOF). Material and methods: Patiens were divided into 4 groups according to trauma severity (Injury Severity Score). The group I. contains patiens with ISS up to 17. There is no premise of the SIRS development. In the group II. there were patiens with ISS 18 ? 30, which means poltrauma group due to new definition. In the group III. there were patiens with ISS 31 ? 40 (severe trauma). Group IV. contains critically injuried patients (ISS 41 and higher). Some patients involved in our study were given indomethacin (as cyclooxygenase inhibitor in arachidonic acid cycle) together with standard therapy. Results: 65 patients were included into study in last 14 months, 22 patients were given indomethacin. The group with indomethacin administration has later increase of inflammatory markers in groups III. and IV. This increase also takes less time in groups II. and III. Shorter time of mechanical ventilation support in group III. in patients with indomethacin was significant. SIRS is present in time of admission approximately in 44%. All patients have low antioxidants level. 5 patients died in our group, letality was 7,7%. All the died patients came from the subgroup without indomethacin, however only one death caused by MOF. Conclusion: From the results of the first 14 months of the study we can conclude that certain number of patients with serious blunt thoracic trauma could benefit from indomethacin administration.	polytrauma ? SIRS ? MOF

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