Systemic hormonal, electrolyte, and substrate changes after non-thermal limb injury in children

Relatively little is known regarding the hormonal changes after injury in c hildren. Adult protocols are often applied to children, although the latter often have different physiological responses to trauma. Twenty children wi th an angulated displaced fracture of the radius and/or ulna (injury severi ty score 9) were studied prospectively for changes in adrenaline, noradrena line, cortisol, angiotensin II, arginine vasopressin, urea, electrolytes, a nd glucose. Two blood samples were taken: one on arrival at the accident an d emergency department and one preoperatively several hours later. There we re marked increases in adrenaline, noradrenaline, cortisol, and arginine va sopressin above the normal range. Five (25%) cases demonstrated greater ear ly increases in adrenaline than those reported for adult injuries of simila r severity. Early hypokalaemia in four cases had corrected towards normal w ithin a few hours without potassium supplementation.