ASSESSMENT OF FUNCTIONAL SYSTEM REGULATION IN PATIENTS WITH SEVERE BURNS IN THE PERIOD OF BURN SHOCK
https://doi.org/10.21886/2219-8075-2016-2-17-22
Abstract
Рurpose: to demonstrate the ability to assess the state regulation system in patients with severe burns, using the tetrad of Gale and scale of pain. Materials and methods: we assessed the functional regulation of the system of 150 patients. All patients were treated in the clinic of thermal injuries from 2005 to 2012. Patients were divided into three groups, depending on the severity of burn shock. We assessed the execution of the tetrad Gale and the level of pain on a 10-point scale. The tetrad of Gale was scored on a scale from 0 to 5 units. This assessment was performed on admission, one day, two days. Results: meaning of the tetrad of Gale varies depending on the disturbance of consciousness. The correct interpretation allows to evaluate the functioning of the system of the regulation. 34% of patients with burn disease were able to perform elements of the tetrad of Gale. Others have a abnormalities associated with various events of pre-hospital care and the patient’s condition. Pain reaction were assessed in different periods after burn injury. Also pain responses in different degrees of burn shock were evaluated. We have found that the most severe pain from admission decreases to the time elimination of burn shock. Summary: determination dysregulation system allows purposefully to influence the pathogenesis in a particular situation.
About the Author
A. L. Admakin
Medical Military Academy named S.M.Kirov.
47 Zagorodny st., St. Petersburg, 190013, Russia
Russian Federation
Russian Federation
References
1. Алексеев А.А. Актуальные вопросы организации и состояние медицинской помощи пострадавшим от ожогов в Российской Федерации / А.А.Алексеев, В.А.Лавров // II Съезд комбустиологов России. – Сб. науч. тр. – М., 2008. – С. 3-5.
2. Алексеев А.А. Ожоговый шок: проблемы остаются / А.А.Алексеев, Т.А.Ушакова // IV Съезд комбустиологов России. – Сб. науч. тр. – М., 2010. – С. 40.
3. Morbidity and survival probability in burn patients in modern burn care / Jeschke MG1, Pinto R, Kraft R. et al. // Crit. Care Med. – 2015. – №43(4). – P. 808-15.
4. Крутиков, М.Г. Ожоговая болезнь и сепсис в свете теорий «адаптационного синдрома» и «системного восполитель- ного ответа» / М.Г. Крутиков // Мир без ожогов: Сб. науч. трудов I Съезда комбустиологов России. – Москва, 2005. – С.62-63.
5. Шанин, Ю.Н. Послеоперационное обезболивание как элемент системы интенсивного наблюдения, профилактики, лечения и реабилитации раненых и больных / Ю.Н.Шанин // Клиническая патофизиология. – 2011. – №1-2-3. – С.3-18.
6. Шанин, Ю.Н. Вадемекум / Ю.Н.Шанин, Б.Н.Котив, В.И.Ионцев // СПб., 2013. – 64 с.
7. Castro, R.J. Pain management in burn patients / R.J. Castro, P.C. Leal, R.K. Sakata // Braz. J. Anesthesiol. – 2013. – Т.63. – №1. – Р.149-53.
8. Breivik, H. Assessment of pain / H.Breivik, P.C.Borchgrevink, S.M.Allen, et al. // British Journal of Anaesthesia. – 2008. – №101 (1). – Р.17–24.
9. Арбух Д. Обзор механизмов хронической боли и рациональное применение лекарственных препаратов в лечении хронического болевого синдрома / Д. Арбух // Всеросс. конгр. анест. и реан. XI съезд Федер. анест. и реан. – Сборн. науч. тр. – 2008 . – С. 3-12.
10. The management of pain associated with wound care in severe burn patients in Spain / Mendoza A., Santoyo F.L., Agulló A. et al. //Int. J. Burns Trauma. – 2016. – №6(1). – Р.1-10.
11. Singleton A. Sedation and analgesia for critically ill pediatric burn patients: the current state of practice / A.Singleton, R.J.Preston, A.Cochran // J. Burn Care Res. – 2015. – №36(3). – Р.440-5.
12. Difficulties in controlling mobilization pain using a standardized patient-controlled analgesia protocol in burns / Nilsson A., Kalman S., Sonesson L.K. et al. // J. Burn Care Res. – 2011. - №32(1). - Р.166-71.
13. Хоженко, Е.В. Болевой синдром и нейроэндокринные нарушения при посттравматическом стрессовом расстройстве / Е.В. Хоженко // Военно-медицинской журнал, 2008. – N4. – С.30-34.
14. Розин, Л.Б. Обезболивание у обожженных / Л.Б. Розин // Л.: Медицина, 1970 – 216 с.
15. Овсянников, В.Г. Особенности патогенеза висцеральной боли / В.Г.Овсянников, С.В.Шлык, А.Е.Бойченко // Медицинский вестник Юга Росии. – 2013. – №3 – С.12-19.
16. Seol, T.K. Propofol-ketamine or propofol-remifentanil for deep sedation and analgesia in pediatric patients undergoing burn dressing changes: a randomized clinical trial / T.K. Seol, J.K.Lim, E.K.Yoo et al. // Paediatr Anaesth. – 2015. – Т.25. – №6. – Р.560-6.
17. Small, C. Virtual restorative environment therapy as an adjunct to pain control during burn dressing changes: study protocol for a randomised controlled trial / C. Small, R. Stone, J. Pilsbury et al. // Trials. – 2015. – №16. – 239 с
Review
For citations:
Admakin A.L. ASSESSMENT OF FUNCTIONAL SYSTEM REGULATION IN PATIENTS WITH SEVERE BURNS IN THE PERIOD OF BURN SHOCK. Medical Herald of the South of Russia. 2016;(2):17-22. (In Russ.) https://doi.org/10.21886/2219-8075-2016-2-17-22
Views:
610
Email this article 