ANAESTHESIOLOGIC MANAGEMENT OF MULTIPLE T RAUMA IN CHILDREN

There are only few clinical studies concerning pediatric patients, maj or guidelines of pediatric trauma management result from studies and e xperiences in adult patients. Anaesthesiological management of pediatr ic patients with major trauma requires profound knowledge of the physi ology and pathophysiology in infants and children. In contrast to adul ts, mechanisms to compensate major blood loss differ in children, sign s of injury are often subtle and the assessment of consciousness and c irculation is often limited, Frequently, early tracheal intubation is necessary to provide adequate analgesia and anaesthesia. In addition, intubation facilitates ventilation and oxygenation. However, airway ma nagement in children is more often conflicted with complications than in adults, Restitution of intravascular volume with cristalloid and co lloid solutions or blood components aims at normovolemia and sufficien t oxygen carrying capacity. Dilution coagulopathy; hypothermia, hypoca lcemia, and in some cases unintended hypervolemia mag result from mass ive transfusion, In severe head injury neurological outcome may be imp aired by hypotension, hypoxia and cerebral hypoperfusion. Therefore, c ontinuous monitoring of important vital parameters such as blood press ure, intracranial pressure, body temperature, oxygenation and ventilat ion are necessary, Diagnostic procedures, surgical interventions and a naesthesiological management of pediatric trauma patients should resul t in optimal organ function, Continuous care of pediatric trauma patie nts should be provided by qualified intensive care units.