APPLICATION OF MAGNESIUM SULFATE AS PART OF AN IMMEDIATE ANESTHETIC PROVIDING OF URGENT SURGICAL INTERVENTION FOR PATIENTS WITH COMBINED TRAUMA IN A STATE OF HEMORRHAGIC SHOCK
About the author:
Biletskiy O. V.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
The problem of improvement of central and peripheral hemodynamics is a leading problem of intensive care in the victims of traumatic shock. One of the mechanisms of cells lesion in shock conditions is the excessive inflow of ionized calcium to them. Hypertonic solution of magnesium sulfate, on the one hand, helps accelerate the recovery of volume of intravascular circulating fluid due to the osmotic mechanism of attracting free water to the vessels from the interstitial, and on the other hand, prevents ionized calcium from entering cells due to blocking ionic calcium channels. This is precisely the advantage of using hypertonic solutions of magnesium sulfate over sodium-based hypertonic solutions, which also help to restore the volume of circulating blood, but they damage the cells. The purpose of the work was to study the effect of preventive use of hypertonic solution of magnesium sulfate on the state of hemodynamics in patients with combined trauma, received by the operating room in the state of traumatic shock. In the two groups of patients suffering from a combined injury in a state of hemorrhagic shock at the early stage of the hospital hemodynamic effects of immediate fluid resuscitation were studied. For 24 patients, fluid resuscitation carried out in accordance with the protocols of the Ministry of Health of Ukraine. Another 24 patients in the fluid resuscitation added the use of hypertonic solution of magnesium sulfate in normal saline. A dose of 25% magnesium sulfate solution was 0.4 ml/kg body weight. Heart rate, all blood pressure indices, oxygen saturation of capillary blood, a perfusion index reflecting the state of peripheral capillary blood flow, and a plethysmographic variability index characterizing the hemodynamic stability are controlled. In a comparative study stated that the addition of hypertonic solution of magnesium sulfate contributed to the acceleration of improvement of the indicators of central and peripheral hemodynamics, as well as its stabilization.
combined trauma, shock, hemodynamics, fluid resuscitation, magnesium
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 2 (144), 2018 year, 142-145 pages, index UDK 616-001.36-005.1-035.1-073-092.6:616-08-035/039