Infusion and transfusion therapy for victims with penetrating head wounds in preparation for aeromedical evacuation

Abstract

Purpose - to assess the effectiveness and scope of infusion and transfusion therapy for wounded with penetrating head wounds at the stage of stabilization and preparation for aeromedical evacuation.

Materials and methods. A retrospective analysis of the medical records of 122 servicemen who were injured during combat missions was conducted. The Group 1 included 52 servicemen with mine blast thoracoabdominal wounds; the Group 2 - 40 servicemen with penetrating head wounds; the Group 3 - 30 servicemen with combined penetrating head wounds and mine blast thoracoabdominal wounds. The study shows the median and interquartile range of the values of the studied indicators. The Kruskal-Wallis test was used to analyze the data, and a posteriori comparisons were made using the Dunn’s test.

Results. A retrospective analysis of the medical records of 122 servicemen who were injured during combat missions was conducted. The total volume of haemotransfusion in the victims of the Group 1 was 1525 (445-2325) ml, in the Group 2 - 0 (0-0) ml, in the Group 3 - 1150 (0-1800) ml. The volume of infusion therapy at the stabilization stage in the Group 1 was 3150 (2450-4200) ml, in the Group 2 - 1200 (800-1400) ml, in the Group 3 - 1400 (880-3200) ml. In the Group 1, the shock index (SI) decreased to 0.67 (0.61-0.71), in the Group 2 - to 0.58 (0.55-0.66), in the Group 3 - to 0.66 (0.61-0.71). The correlation analysis in the Groups 1 and 3 revealed a negative correlation of medium severity between the amount of haemotransfusion and the change in SI (ρ=-0.353 at p=0.01; ρ=-0.525 at p=0.003).

Conclusions. Infusion and transfusion therapy in the prescribed volumes allowed to reduce the rate of SI in wounded servicemen by 23.7% (95% CI: 19.2-29.5%). Victims of the Group 3 required a greater volume of infusion and transfusion therapy, which affected the time required to prepare for aeromedical evacuation.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the paper. The informed consent of the patient was obtained for conducting the studies.

No conflict of interests was declared by the authors.