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Polyuria with marked plasma sodium disturbance was present in 39 of 224 patients with isolated craniocerebral war injuries. Twenty-one of these 39 patients had hyponatremia (sodium level < 130 mmol/l) and polyuria. Eight of them (38%) died within 30 days after trauma. The remaining 18 patients developed classic diabetes insipidus syndrome, and 6 of them (33%) died of hypernatremia within 30 days after trauma. The mortality in both patients with hyponatremia and patients with diabetes insipidus was higher in those with greater disturbances of plasma sodium concentration with polyuria and those with lower Glasgow Coma Scale scores.

Introduction: A retrospective study on the occurrence of septic syndrome and septic shock, as well as multiorgan failure, in the wounded at the Split Clinical Hospital Intensive Care Unit (ICU)., Patients and Methods: From 1991 to 1995, 257 wounded persons were treated at the Split Clinical Hospital ICU. Criteria for septic syndrome included evident infection, body temperature > 38 degrees C or < 30.5 degrees C, leukocytosis or leukopenia, thrombocytopenia, as well as dysfunction of one organ. The criterion for septic shock was septic syndrome with hypotonia., Results: Fifteen patients with septic syndrome and 9 patients with septic shock were admitted and treated at the ICU. Septic syndrome developed in 17 patients and septic shock in 16 patients at the ICU. Acute respiratory distress syndrome developed in 16, renal insufficiency in 26, gastrointestinal disorders in 6, hepatic disorders in 4, hematologic disorders in 13, and central nervous system dysfunction in 17 patients. Twenty-eight percent of patients died in septic syndrome, and 74% died in septic shock., Conclusion: Septic syndrome and septic shock were the most common causes of death in wounded persons treated at Split Clinical Hospital ICU. At the earliest phase the main cause of death was refractory hypotension, and at the later stage the main cause of death was multiorgan failure.

In the Rama mobile war hospital, intravenous (i.v.) anaesthesia was used in 78 patients undergoing surgical procedures lasting 4-25 min. Boluses of thiopentone (Group 1), propofol (Group 2), propofol + alfentanyl (Group 3), and ketamine + midazolam (Group 4) were used. Induction of anaesthesia, resulted in a mean blood pressure decreased about 15%. Apnoea of more than 20 sec was observed in Group 3, but no naloxone was required. Recovery was rapid enabling patients to maintain their own airway. The use therefore of titrated anaesthetics in war is considered acceptable.