Current challenges of intensive care in children affected by the war in Ukraine

Abstract

Background. Treatment of children with combat injuries due to the war in Ukraine requires intensive care and high professionalism. The purpose of study was to demonstrate the experience of providing intensive care to children affected by the war in Ukraine and to discuss the implementation of international standards for providing medical aid to such patients at the stages of evacuation from the war zone. Materials and methods. We have examined and provided intensive care to 15 children aged 1 month — 18 years old with combat injuries due to hostilities in Ukraine. Literature search was performed in PubMed databases using the keywords “combat trauma in children, “blast injuries in children”, “intensive care of children with tertiary peritonitis”, “acute and chronic pain”, “acute psychiatric disorders in children”, “sepsis and septic shock in children”, “multiresistant nosocomial infections”. Results. The main clinical problems of people affected by hostilities were: acute and chronic pain, acute psychiatric disorders (psychosis, hallucinatory syndrome, agitation), sepsis and colonization by multiresistant nosocomial pathogens, especially if a patient was previously treated in the intensive care unit for more than 2 weeks (pneumonia, wound infections), gastrointestinal failure syndrome, gastroparesis, tertiary peritonitis, nutrient deficiency, prolonged mechanical ventilation and difficulty weaning from it. All patients received multidisciplinary care. Conclusions. Thus, our experience of treating children requiring intensive care after war injuries indicates that such patients have a combination of many clinical problems already known to clinicians, which are typical for both long-term intensive care patients, and those with severe injuries.