Anaesthesiologic management of multiple trauma in children

There are only few clinical studies concerning pediatric patients, major guidelines of pediatric trauma management result from studies and experiences in adult patients. Anaesthesiological management of pediatric patients with major trauma requires profound knowledge of the physiology and pathophysiology in infants and children. In contrast to adults, mechanisms to compensate major blood loss differ in children, signs of injury are often subtle and the assessment of consciousness and circulation is often limited, Frequently, early tracheal intubation is necessary to provide adequate analgesia and anaesthesia. In addition, intubation facilitates ventilation and oxygenation. However, airway management in children is more often conflicted with complications than in adults, Restitution of intravascular volume with cristalloid and colloid solutions or blood components aims at normovolemia and sufficient oxygen carrying capacity. Dilution coagulopathy; hypothermia, hypocalcemia, and in some cases unintended hypervolemia mag result from massive transfusion, In severe head injury neurological outcome may be impaired by hypotension, hypoxia and cerebral hypoperfusion. Therefore, continuous monitoring of important vital parameters such as blood pressure, intracranial pressure, body temperature, oxygenation and ventilation are necessary, Diagnostic procedures, surgical interventions and anaesthesiological management of pediatric trauma patients should result in optimal organ function, Continuous care of pediatric trauma patients should be provided by qualified intensive care units.