Department of anesthesiology and intensive care, Bégin Military Teaching Hospital, Saint-Mandé, France.
Department of anesthesiology and intensive care, Bégin Military Teaching Hospital, Saint-Mandé, France.
Anaesth Crit Care Pain Med. 2024 Oct;43(5):101409. doi: 10.1016/j.accpm.2024.101409. Epub 2024 Jul 30.
The war in Ukraine provides purposefully anesthesiologists and intensivists with important data for improving the management of trauma patients. This scoping review aims to investigate the specific management of war-related trauma patients, during the war in Ukraine, through an objective and comprehensive analysis.
A comprehensive search of the Embase, Medline, and Open Grey databases from 2014 to February 2024 yielded studies focusing on anesthesia and surgery. These studies were assessed by PRISMA and STROBE criteria and needed to discuss anesthesiology and surgical procedures.
Of the 519 studies identified, 21 were included, with a low overall level of evidence. The studies covered 11,622 patients and 2470 surgical procedures. Most patients were Ukrainian men, 25-63 years old, who had sustained severe injuries from high-energy weapons, such as multiple rocket systems and combat drones. These injuries included major abdominal, facial, and extremity traumas. The surgical procedures varied from initial debridement to complex reconstructions. Anesthesia management faced significant challenges, including resource scarcity and the need for quick adaptability. Evacuations of casualties were lengthy, complex, and often involved rail transportation. Hemorrhage control with tourniquets was critical but associated with many complications. The very frequent presence of multi-resistant organisms required dedicated preventive measures and appropriated treatments. The need for qualified human resources underscored the importance of civilian-military cooperation.
This scoping review provides original and relevant insights on the lessons learned from the ongoing war in Ukraine, which could be useful for anesthesiologists and intensivists.
乌克兰战争为麻醉师和重症监护医生提供了重要数据，有助于改进创伤患者的管理。本范围综述旨在通过客观全面的分析，研究乌克兰战争期间与战争相关的创伤患者的具体管理。
从 2014 年至 2024 年 2 月，对 Embase、Medline 和 Open Grey 数据库进行全面检索，筛选出聚焦于麻醉和手术的研究。这些研究采用 PRISMA 和 STROBE 标准进行评估，并需要讨论麻醉学和外科手术。
在 519 项研究中，有 21 项研究符合纳入标准，总体证据水平较低。这些研究涵盖了 11622 名患者和 2470 例手术。大多数患者为乌克兰男性，年龄 25-63 岁，遭受了来自多管火箭系统和战斗无人机等高能武器的严重伤害，包括严重的腹部、面部和四肢创伤。手术程序从初步清创到复杂重建不等。麻醉管理面临着重大挑战，包括资源匮乏和快速适应的需要。伤员的后送冗长、复杂，通常涉及铁路运输。使用止血带控制出血至关重要，但也会引起许多并发症。多耐药生物体的频繁出现需要专门的预防措施和适当的治疗。合格人力资源的需求突显了军民合作的重要性。
本范围综述提供了关于乌克兰正在进行的战争中吸取的经验教训的原始和相关见解，这可能对麻醉师和重症监护医生有帮助。
