Hypothermia, Coagulopathy And Acidosis In Trauma Patients, Prev Alence In The Perioperpative Period And Management

Trauma is a common health problem in the developed and developing countries. Hypothermia, coagulopathy and acidosis are triade commonly developed in traumatized patients.The aim of this study is evaluation of prevelance, causes and effects of hypothermia, coagulopathy and acidosis in trauma patients and management.One hundred trauma patients were included in this study with one or more of the following criteria:- Hemodynamic unstability, presenting coagulopathy and/or hypothermia.- Polytraumatized patients (two or more systems affection).- Patients with Revised Trauma Score  6.Resuscitation was performed for all patients in ER according to Advanced Trauma Life Support Guidelines. Core body temperature, ABG and coagulation studies were recorded initially and then monitored continuously.After initial stabilization of the patients, essential radiological investigation were done then the patients were taken either to ICU or operating room (OR).Patient who needed surgical intervention were transported to OR where continous resuscitation and monitoring were done in addition to measures to prevent and treat hypothermia, coagulopathy and acidosis.In ICU resuscitation and monitoring of core body temperature, coagulation studies and ABG were continued up to 48 hour after trauma as planned in this study.The results of this study included the followings:- Trauma is more common among age group between 21-30 years (32 patients).- Trauma is more common in males (68 patients) while female (32 patients).- Motor vehicle accidents is the commonest mode of trauma (78%) while falling from height (12%) and penetrating injury (10%).- Revised Trauma Scoring was done for all patients. Those with RTS  6 was 26 patients.- The mean time lapsed from occurrence of trauma till arrival of patients to the hospital 9045 minutes.- The mean time in ER was 7045 minutes.- The mean operative time was 15040 minutes.- Monitoring of patients in ICU continued up to 48 hours after occurrence of trauma.- Hypothermia developed in 68% of patients with varying degrees (mild 50, moderate 13 and severe 5).- Coagulopathy developed in 35% of patients.- Acidosis developed in 53% of patients.- Mortality rate among the patients in this study within the planned period (48 h.) was 22% (22 patients) (4 cases in ER, 6 in OR and 12 in ICU).