Management of adult severe trauma patients in polyvalent intensive care unit at university hospital of Brazzaville

Aim > To describe the management of severe trauma adult patients admitted to polyvalent intensive care unit at the university hospital of Brazzaville (CHU-B). Materials and methods > This was a retrospective and cross-sectional study performed in polyvalent intensive care unit of the CHU-B during 30 months. We included all severe trauma patients aged at least 18 years old and managed in intensive care unit for at least 6 hours. The following variables were studied: sociodemographic, clinical, therapeutic and outcome data. These data were analysed using Excel 2016 and Epi-info version 7 for Windows. Results > Seventy patients were included in our study. The mean age of our patients was 39 +/- 15 years with a sex ratio of 4.8. Half of the patients (50%) came from the emergency department of CHU-B. Road traffic collisions (84.3%) were the most common mechanism of injury involved. At admission, 47.2% of patients had severe traumatic brain injury; of whom 27.1% were isolated. Respiratory distress and shock were observed in 38.6% and 14.6% of cases respectively. Collection and transportation of patients were not medicalised. Management of these patients consisted of vascular filling with crystalloids and colloids solutions, oxygen therapy (84.3%), blood transfusion (30%), use of vasopressor amines (34.3%), and osmotherapy (10%). Thoracic drainage was performed in 9.9% of cases; the patients were intubated and sedated in 40% of cases. Management surgical was performed in 21.4% of patients. All patients received analgesic treatment involving different levels. Antibiotic therapy was administered in 74.7% of patients. The mortality rate was 41.4%. Conclusion > Severe trauma or polytrauma are a common reason for admission in intensive care unit. They mostly affect the young male population and are consecutive to road traffic collisions. Their management although codified remains insufficient because of their high mortality rate.