Catherine Carlile1, Charles E Wade2, Mary Sarah Baraniuk2, John B Holcomb2, Laura J Moore2. 1. Department of Surgery, University of Texas Medical School at Houston, Center for Translational Injury Research (CeTIR), 6410 Fannin Street UPB 1100, Houston, TX, 77030, USA. Electronic address: Catherine.R.Carlile@uth.tmc.edu. 2. Department of Surgery, University of Texas Medical School at Houston, Center for Translational Injury Research (CeTIR), 6410 Fannin Street UPB 1100, Houston, TX, 77030, USA.
Abstract
BACKGROUND: Hemorrhage remains the leading cause of mortality in preventable trauma deaths. Earlier recognition of hemorrhagic shock decreases the time to implementation of life-saving interventions improves patient survival. The presence of hemorrhagic shock is not always apparent using standard vital signs monitoring, a clinical state referred to as occult shock. METHODS: This prospective, observational study was performed at Memorial Hermann Hospital in Houston, TX. Prisoners, pregnant women, and patients with burn injuries greater than 20% total body surface area or bilateral upper extremity fractures were excluded. Hutchinson Technologies Spot Check StO2 device was used to measure StO2 values. RESULTS: StO2 values less than 75% were predictive of the need for blood product transfusions (P < .01) and the need for emergency surgeries. Nearly one-third of patients who presented with a systolic blood pressure 120 mm Hg or more presented with StO2 less than 75% and had a median base deficit of 5 (3 to 6.5). CONCLUSIONS: Admission StO2 measurements less than 75% predict the need for blood products and emergent surgical procedures and may be used as an adjunct method for identifying shock. StO2 measurements can aid where laboratory values are unavailable.
BACKGROUND:Hemorrhage remains the leading cause of mortality in preventable trauma deaths. Earlier recognition of hemorrhagic shock decreases the time to implementation of life-saving interventions improves patient survival. The presence of hemorrhagic shock is not always apparent using standard vital signs monitoring, a clinical state referred to as occult shock. METHODS: This prospective, observational study was performed at Memorial Hermann Hospital in Houston, TX. Prisoners, pregnant women, and patients with burn injuries greater than 20% total body surface area or bilateral upper extremity fractures were excluded. Hutchinson Technologies Spot Check StO2 device was used to measure StO2 values. RESULTS:StO2 values less than 75% were predictive of the need for blood product transfusions (P < .01) and the need for emergency surgeries. Nearly one-third of patients who presented with a systolic blood pressure 120 mm Hg or more presented with StO2 less than 75% and had a median base deficit of 5 (3 to 6.5). CONCLUSIONS: Admission StO2 measurements less than 75% predict the need for blood products and emergent surgical procedures and may be used as an adjunct method for identifying shock. StO2 measurements can aid where laboratory values are unavailable.
Authors: Franz Haertel; Diana Reisberg; Martin Peters; Sebastian Nuding; P Christian Schulze; Karl Werdan; Henning Ebelt Journal: J Clin Med Date: 2022-03-04 Impact factor: 4.241