Pulmonary Embolism in Polytrauma: Diagnosisand Treatment

Abstract

Treatment of patients with polytrauma is a difficult problem for surgeons and physicians of intensive care units due to the fact that a multiple and complex lesion often serves as a trigger for the development of a number of life-threatening complications, such as pulmonary embolism (PE). Despite the existing methods of prevention and treatment of pulmonary embolism, the development of this complication in patients with polytrauma accompanied by massive hemorrhageisstill remains an unsolved problem. This article presents a clinical case of the development of isolated PE during performing osteosynthesis of the patient with polytrauma and in stable condition achieved after the intensive therapy within the week. The analize of studies considering the problem of thrombus formation in various parts of the vascular bed and considering of pathophysioliogycal mechanisms of the systemicinflammatory response has been performed. Riskfactors forpulmonary embolism and methods of prophylaxis are studied. Taking into consideration the currently available research data dedicated to this issue, the idea about the generalized nature of the pathological process which can be manifested as deep vein thrombosis such as PE or their combination has been expressed. In respect the insufficient effectiveness of thromboprophylaxis, the need to work out the other or additional laboratory and diagnostic methods of blood coagulation system assessment and responsively therapeutic methods is being considered.