Monitoring and treatment of severe complications of multiple-trauma patients in intensive care unit

CHEN Xi; ZHOU Jian; WANG Yao-li; ZHANG Lian-yang; JIANG Jian-xing

doi:10.3969/j.issn.1009-4237.2017.05.002

Abstract：Objective To make a summary of the incidence and treatment experience of multiple-trauma patients with serious complications in intensive care units. Methods The clinical data of 150 multiple-trauma patients with serious complications(such as traumatic shock,trauma triad of death,sepsis,abdominal compartment syndrome,acute respiratory distress syndrome,acute kidney injury and acute gastrointestinal injury) in ICU of Daping Hospital from Jan.2013 to Jan.2016 were retrospectively analyzed and the incidence,clinical monitoring and treatment and the cure rate of these patients were summarized. Results Among the 150 patients,109 had traumatic shock (72.7%);89 had trauma lethal triad (59.3%),including 7 cases of disseminated intravascular coagulation (4.7%), and 3 deaths(2%);41 cases had sepsis(27.3%),including 14 cases of sepsis shock(9.3%);22 cases had abdominal compartment syndrome (14.7%),including 2 deaths (1.3%);36 cases had acute respiratory distress syndrome (24.0%),including 1 death(0.6%);37 cases had acute kidney injury(24.7%),and 53 had acute gastrointestinal injury (35.3%).The ICU stay of 150 patients ranged 5 to 36 days,with an average of 8.9 days.Totally 136(90.7%) of them were smoothly transferred to other departments,and 8 cases (5.3%) were discharged and 6 cases (4%) died. Conclusion There is a high rate of complications in multiple-trauma patients.Most of them suffer from traumatic shock.Meanwhile,the mortality rate of disseminated intravascular coagulation is the highest among the patients,and abdominal compartment syndrome has the second highest mortality rate.Therefore,it is important to keep close monitoring on the multiple-trauma patients for the prevention and treatment of the complications.