scholarly journals Comparison of Base Deficit and Vital Signs as Criteria for Hemorrhagic Shock Classification in Children with Trauma

2021 ◽  
Vol 62 (4) ◽  
pp. 352
Author(s):  
Yura Ko ◽  
Jung Heon Kim ◽  
Kyungjin Hwang ◽  
Jisook Lee ◽  
Yo Huh
Keyword(s):  
Hemorrhagic Shock ◽  
Vital Signs ◽  
Base Deficit

scholarly journals Investigating the relationship between hemodynamic and metabolic parameters in portal triade occlusion following hemorrhagic shock

2005 ◽  
Vol 20 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Mauro José Fontelles ◽  
Mario Mantovani ◽  
Elcio Shiyoiti Hirano ◽  
Rosana Celestina Morandin
Keyword(s):  
Hemorrhagic Shock ◽  
Serum Lactate ◽  
Base Deficit ◽  
Shock State ◽  
Portal Triad ◽  
Value Analysis ◽  
Proportional Relationship ◽  
Pringle’S Maneuver ◽  
The Relationship ◽  
Mathematical Coupling

PURPOSE: To determine whether metabolic and hemodynamic parameters are "mathematically" coupled in rats submitted to portal triad occlusion following controlled hemorrhagic shock state. METHODS: Pearson's coefficient (r-value) analysis was performed. Differences considered significant at p<0.05 and -0.50>r>0.50. RESULTS: It was observed that there is a direct proportional relationship to HCO3- with pCO2 (r=0.66), base deficit (r=0.87) and inverse with serum lactate (r=-0.54). pCO2 was directly associated with MAP (r=0.51), and inversely with pH (r=-0.64). Hematocrit was directly associated with HR (r=0.72) and CI (r=0.76), and serum lactated was inversely associated with base deficit (r=-0.61). CONCLUSION: In rats submitted to Pringle's maneuver during 15 minutes following hemorrhagic shock state, there is a mathematical coupling with a very good correlation between several hemodynamic and metabolic variables.

scholarly journals Is the Whole Greater than the Sum of Its Parts? The Implementation and Outcomes of a Whole Blood Program in Ecuador

2021 ◽  
Author(s):  
Amber Nicole Himmler ◽  
Monica Eulalia Galarza Armijos ◽  
Jeovanni Reinoso Naranjo ◽  
Sandra Gioconda Peña Patiño ◽  
Doris Sarmiento Altamirano ◽  
...  
Keyword(s):  
Latin America ◽  
Hemorrhagic Shock ◽  
Whole Blood ◽  
Vital Signs ◽  
Human Albumin ◽  
Acute Care Surgery ◽  
Trauma Patients ◽  
Transfusion Reaction ◽  
Shock Index ◽  
Care Surgery

Abstract Background: Hemorrhagic shock is a major cause of mortality in low-and-middle-income countries (LMICs). Many institutions in LMICs lack the resources to adequately prescribe balanced resuscitation. This study aims to describe the implementation of a whole blood program in Latin America and to discuss the outcomes of the patients that received whole blood (WB).Methods: We conducted a retrospective review of patients resuscitated with WB from 2013-2019. Five units of O+ WB were made available on a consistent basis for patients presenting in hemorrhagic shock. Variables collected included: gender, age, service treating the patient, units of WB administered, units of components administered, admission vital signs, admission hemoglobin, Shock Index, Revised Trauma Score (RTS) in trauma patients, intraoperative crystalloid (lactated ringers or normal saline) and colloid (5% human albumin) administration, symptoms of transfusion reaction, length-of-stay and in-hospital mortality.Results: The sample includes a total of 101 patients, 57 of whom were trauma and acute care surgery (TACS) patients and 44 of whom were obstetrics and gynecology patients. No patients developed symptoms consistent with a transfusion reaction. Average shock index was 1.16 (±0.55). On average, patients received 1.66 (±0.80) units of whole blood. Overall mortality was 14/101 (13.86%) in the first 24 hours and 6/101 (5.94%) after 24 hours.Conclusion: Implementing a WB protocol is achievable in LMICs. Whole blood allows for more efficient delivery of hemostatic resuscitation and is ideal for resource-restrained settings. To our knowledge, this is the first description of a whole blood program implemented in a civilian hospital in Latin America.

Mortality Risk Stratification in Elderly Trauma Patients Based on Initial Arterial Lactate and Base Deficit Levels

2011 ◽  
Vol 77 (10) ◽  
pp. 1337-1341 ◽  
Author(s):  
Angela L. Neville ◽  
Denis Nemtsev ◽  
Raed Manasrah ◽  
Scott D. Bricker ◽  
Brant A. Putnam
Keyword(s):  
Blood Pressure ◽  
Risk Stratification ◽  
Systolic Blood Pressure ◽  
Vital Signs ◽  
Base Deficit ◽  
Trauma Patients ◽  
Arterial Lactate ◽  
Urban Level ◽  
Level I ◽  
Elderly Trauma Patients

Elderly trauma patients have worse outcomes than their younger counterparts. Early risk stratification remains difficult, particularly because traditional vital signs are less reliable. We hypothesized that arrival lactate and base deficit (BD) could be used to predict mortality in elderly trauma patients with a normal admission blood pressure. We retrospectively evaluated the prospectively collected trauma registry at our urban Level I trauma center between 2003 and 2009. Patients sustaining blunt trauma, age 55 years or older, with a systolic blood pressure 90 mmHg or higher, and who had arterial lactate and/or BD measured within 4 hours of arrival comprised the study group. Primary outcomes were in-hospital and 24-hour mortality. There were 364 patients with a lactate and 324 with a BD drawn. Patients with a lactate 2.5 mmol or greater were 3.7 times more likely to die than those with a lactate less than 2.5 mmol (95% CI, 1.6 to 8.2; P = 0.0018). The OR for mortality was 5.2 (95% CI, 2.5 to 11.2; P < 0.0001) in patients with a BD -4 or less. Elevated lactate and BD were even stronger predictors of early mortality (within first 24 hours). After increasing the hypotension threshold to a systolic blood pressure 110 mmHg or greater, lactate and BD remained highly predictive of in-hospital and 24-hour mortality.

A Pilot Comparison of Limited Versus Large Fluid Volume Resuscitation in Canine Spontaneous Hemoperitoneum

2014 ◽  
Vol 50 (3) ◽  
pp. 159-166 ◽  
Author(s):  
Tara N. Hammond ◽  
Jennifer L. Holm ◽  
Claire R. Sharp
Keyword(s):  
Hemorrhagic Shock ◽  
Vital Signs ◽  
Fluid Volume ◽  
Volume Resuscitation ◽  
Hemodynamic Parameters ◽  
Future Studies ◽  
Time Points ◽  
Spontaneous Hemoperitoneum ◽  
Time To Stabilization ◽  
Potential Benefits

Treatment for hemorrhagic shock secondary to a spontaneous hemoperitoneum includes restoration of IV volume and surgical control of hemorrhage. This study was designed to determine if limited fluid volume resuscitation (LFVR) with hypertonic saline (HS) and hyperoncotic fluids (hydroxyethylstarch [HES]) results in more rapid cardiovascular stabilization in dogs with spontaneous hemoperitoneum versus conventional resuscitation (CR) with large volume resuscitation. Eighteen client-owned dogs presenting in hemorrhagic shock with a spontaneous hemoperitoneum were enrolled. Dogs were randomized to be fluid resuscitated with up to 90 mL/kg of an isotonic crystalloid (CR group) or up to 8 mL/kg of 7.2% Na chloride (i.e., HS) combined with up to 10 mL/kg of 6% HES. Measurements of vital signs, lactate, packed cell volume (PCV), total solids (TS), and blood pressure were made at standard time points. The primary end point was time to stabilization of hemodynamic parameters (measured in min). Dogs in the LFVR group achieved hemodynamic stabilization significantly faster (20 min; range, 10–25 min) than those in the CR group (35 min; range, 15–50 min; P = .027). Future studies are warranted to further investigate potential benefits associated with LFVR in dogs with spontaneous hemoperitoneum.

A comparison of base deficit and vital signs in the early assessment of patients with penetrating trauma in a high burden setting

Injury ◽  
2017 ◽  
Vol 48 (9) ◽  
pp. 1972-1977 ◽  
Author(s):  
Mark Peter Dunham ◽  
Benn Sartorius ◽  
Grant Llewellyn Laing ◽  
John Lambert Bruce ◽  
Damian Luiz Clarke
Keyword(s):  
Vital Signs ◽  
Penetrating Trauma ◽  
Base Deficit ◽  
Early Assessment ◽  
High Burden

scholarly journals G-CSF Administration after the Intraosseous Infusion of Hypertonic Hydroxyethyl Starches Accelerating Wound Healing Combined with Hemorrhagic Shock

2016 ◽  
Vol 2016 ◽  
pp. 1-9
Author(s):  
Hong Huang ◽  
Jiejie Liu ◽  
Haojie Hao ◽  
Chuan Tong ◽  
Dongdong Ti ◽  
...  
Keyword(s):  
Wound Healing ◽  
Hemorrhagic Shock ◽  
Normal Saline ◽  
Wound Closure ◽  
Vital Signs ◽  
Treated Group ◽  
Therapeutic Effects ◽  
Cutaneous Injury ◽  
Life Saving ◽  
Hydroxyethyl Starches

Objective.To evaluate the therapeutic effects of G-CSF administration after intraosseous (IO) resuscitation in hemorrhagic shock (HS) combined with cutaneous injury rats.Methods.The rats were randomly divided into four groups: (1) HS with resuscitation (blank), (2) HS with resuscitation + G-CSF (G-CSF, 200 μg/kg body weight, subcutaneous injection), (3) HS with resuscitation + normal saline solution injection (normal saline), and (4) HS + G-CSF injection without resuscitation (Unres/G-CSF). To estimate the treatment effects, the vital signs of alteration were first evaluated, and then wound closure rates and homing of MSCs and EPCs to the wound skins and vasculogenesis were measured. Besides, inflammation and vasculogenesis related mRNA expressions were also examined.Results.IO infusion hypertonic hydroxyethyl starch (HHES) exhibited beneficial volume expansion roles and G-CSF administration accelerated wound healing 3 days ahead of other groups under hemorrhagic shock. Circulating and the homing of MSCs and EPCs at wound skins were significantly elevated at 6 h after G-CSF treatment. Inflammation was declined since 3 d while angiogenesis was more obvious in G-CSF treated group on day 9.Conclusions.These results suggested that the synergistical application of HHES and G-CSF has life-saving effects and is beneficial for improving wound healing in HS combined with cutaneous injury rats.

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