CATATRAUMA IN CHILDREN. INTEGRATIVE APPROACH TO TREATMENT

Abstract

According to WHO data, about 47 thousand of children and adolescents younger 20 die after catatrauma each day world-wide. Proportion of catatrauma among other injuries is 12-19 %, and it takes the second place (about 40 %) in mortality after injuries, conceding to deaths from road traffic accidents (up to 75 %). Catatrauma is a type of an injury after falling from height. This injury mechanism supposes a range of life-threatening injuries (shock, acute massive blood loss, intracranial injuries, skeletal, abdominal and thoracic injuries etc.), resulting in necessity for urgent, immediate medical procedures. The optimal place for treatment of such patients is the multi-profile specialized hospital – level 1 trauma center, where the multidisciplinary approach is realized.

Objective – to show the possibilities of the integrative approach to diagnosis and treatment of a child with catatrauma.

Materials and methods. A case of treatment of catatrauma is presented. It includes the child (age of 8) who fell from the height and received the associated injuries to the chest and abdominal cavity, fractures of the pelvis, forearm bones and humerus, traumatic brain injury (ISS – 54). The complex of efficient medicodiagnostic and organizational procedures is shown, which is characterized by specific difficulty, multiple stages, strict subsequence and individuality.

Results. The child was treated during 52 days, including 29 days in the intensive care unit and 23 days in the profile traumatology unit. After single-stage and subsequent surgical treatment of thoracic and abdominal organs, reposition of extremity bones, long term artificial lung ventilation and complex infusion therapy, the child was discharged in satisfactory condition.

Integration of physicians of different specialties into the process of treatment of the life-threatening pathology allowed optimizing the complex of diagnostic examinations, selection of treatment techniques, and, finally, treating and adapting the child to further life.

Conclusion. The multidisciplinary approach to treatment of a patient with catatrauma allows optimizing diagnosis of common injuries and determining the volume of required treatment. Sequential surgical interventions for thoracoabdominal organs and extremities in the specialized facility allowed achieving the good outcome.