The Influence of Volemic Support with Balanced Crystalloid Solutions on the Dynamics of Peripheral Edema in Patients with Severe Brain Injury

O.H. Kramareva, L.V. Zgrzheblovska, I.R. Malysh

Abstract


Background. Infusion therapy is an integral part of intensive care of patients with severe brain injury, but the effectiveness of infusion-transfusion therapy largely depends on the targeted grounding of its application, characteristics of infusion solutions, their pharmacological properties and pharmacokinetics. At this stage of intensive care choice of solution for volemic support in patients with severe brain injury is not resolved. Objective. To optimize the method of volemic support in patients with severe brain injury to reduce the severity of edema syndrome.
Materials and methods. The study involved 60 patients with severe brain injury, aged from 18 to 65 years old, with the level of consciousness 5–11 scores by the Glasgow Coma Scale at admission and 12 hours after the initial resussitation and severity 21 ± 2,7 scores by APACHE II scale. The patients were divided into two groups: control and research. The patients in the control group received volemic support solution NaCl 0.9% by the standard method. The research group received volemic support with balanced crystalloid solution. In both groups indicators of increasing of tissue thickness in the frontal area, the rear foot and the circumference over radiocarpal joint were monitored. Results. According to data of our study of the victims, who carried volemic support with balanced crystalloid solution severity of edema syndrome was less pronounced, as in the study group regression of edema syndrome was observed in 9–10 days of treatment. While in the control group edema remains for 10 days of treatment.
Conclusions. The application of volemic support with balanced crystalloid solution was found to significantly reduce the severity of edema syndrome in patients with severe brain injury during the first 10 days of treatment, to eliminate edema syndrome to the 9th–10th days of treatment, which in turns improves parameters of external respiration, reduces complications in the respiratory system, the duration of artificial pulmonary ventilation, and therefore staying in the emergency unit and duration of treatment.


Keywords


brain injury; volemic support; edema; capillary leak syndrome; balanced crystalloid solution

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DOI: https://doi.org/10.22141/2224-0586.3.74.2016.77554

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