Başkent Üniversitesi Makaleler

Permanent URI for this collectionhttps://hdl.handle.net/11727/13096

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Author: search.filters.author.Adkham AkhmedovSubject: search.filters.subject.Burn injury

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    Treatment of Acute Gastroduodenal Bleeding in Patients With Severe Burn Injuries
    (Başkent Üniversitesi, 2021-12) Abdulaziz Fayazov; Adkham Akhmedov
    OBJECTIVES: Among causes of gastrointestinal bleeding, stress ulcers occupy the second place, second only to chronic ulcers of the stomach and duodenum; gastrointestinal bleeding accounts for 10% to 20% of all causes of hemorrhage. Bleeding relapses from acute stress ulcers (mortality rate range, 60%-90%) are particularly dangerous. Our aim was to compare treatment methods for patients with bleeding from acute gastroduodenal ulcers after severe burns. MATERIALS AND METHODS: Over the past 10 years at our burn department (Samarkand City Medical Association), 80 patients (average age of 51 ± 16 years; 46.4% older than 60 years) with severe burns and bleeding from acute gastroduodenal ulcers were treated. The total area of thermal damage to the skin indicated the significant severity of thermal injury (average of 36.7 ± 7.7% of body surface). Patients were divided into 2 groups: main group (n = 42; 7-day antiulcer therapy) and control group (n = 38; H2-receptor blockers and traditional treatment). RESULTS: In the main group, VEGF concentrations remained virtually unchanged for 3 days compared with that shown in the control group, with a predisposition for gastroduodenal complications but decreased to 18.5% on day 7 and to 24.2% on day 14. In patients without a tendency for gastroduodenal complications, there was a decrease of 10.9% on day 7 and 15.4% on day 14 compared with patients in the control group. Thus, the use of L-arginine-containing drug in the main group of patients on all sampling days resulted in a decrease of VEGF concentration compared with that shown in the control group. CONCLUSIONS: Stable hemostasis during bleeding from acute gastroduodenal ulcers in patients with severe burn injuries was achieved in 77.8% of the control group (who received antisecretory therapy with H2-receptor blockers) and in 88.1% of the main group (antisecretory treatment with addition of dopamine D2-receptor blockers).
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    Prediction of Development of Acute Gastroduodenal Complications in Patients With Severe Burns
    (Başkent Üniversitesi, 2021-09) Abdulaziz Fayazov; Adkham Akhmedov; Akmal Mirzakulov; Abdukakhor Nabiev
    OBJECTIVES: Our aim was to find whether we could predict the likelihood of acute gastroduodenal complications developing in patients with severe burns. MATERIALS AND METHODS: From 2018 to 2020, there were 85 patients with extensive thermal injury and severe burns who were hospitalized at our burn department (Samarkand City Medical Association). Of these, 45 patients (53%) developed acute gastroduodenal complications in the first 7 days postinjury and 40 (47%) did not develop these complications in the first 2 weeks after admission. We analyzed the following 7 parameters: admission time and initiation of intensive care after 12 hours, total burn area of ≥40%, deep burn area ≥10%, lesion severity index (Frank index) of ≥130 units, development of thermal inhalational lesion in the respiratory tract, duration of mechanical ventilation of >48 hours, and history of peptic ulcer disease of >5 years. RESULTS: We found that 57.8% of patients who had postponed hospitalization in a specialized medical institution and started intensive therapy >12 hours later developed acute gastroduodenal complications versus 42.2% of patients without these factors. In those with total burn area <40% and ≥40%, 28.9% versus 71.1% developed acute gastroduodenal complications. At week 2 of burn disease, in patients with deep burn areas ≥10%, acute gastroduodenal complications developed 1.5 times more often. Among patients whose Frank index was ≥130 units, acute gastroduodenal complications developed 9 times more often than among those with Frank index ≤70 units. CONCLUSIONS: The 7 parameters that we used as prognostic criteria could assess patients with extensive thermal injury complicated by the development of burn disease. With these criteria, a scale was created to predict the development of acute gastroduodenal complications. This scale could allow better preparation to treat these complications and to take timely preventive measures.