Steven G Schauer1,2,3, Michael D April4, Allyson A Arana2, Joseph K Maddry1,2,3,5, Mireya A Escandon2, Carlissa D Linscomb2, Dylan C Rodriguez2, Victor A Convertino1,3,6. 1. US Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, Texas, USA. 2. Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas, USA. 3. Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA. 4. 2nd Brigade, 4th Infantry Division, Fort Carson, Colorado, USA. 5. 59th Medical Wing, JBSA Lackland, San Antonio, Texas, USA. 6. Department of Emergency Medicine, University of Texas Heath, San Antonio, Texas, USA.
Abstract
BACKGROUND: The Compensatory Reserve Measurement (CRM) is a novel method used to provide early assessment of shock based on arterial wave form morphology changes. We hypothesized that (1) CRM would be significantly lower in those trauma patients who received life-saving interventions compared with those not receiving interventions, and (2) CRM in patients who received interventions would recover after the intervention was performed. STUDY DESIGN AND METHODS: We captured vital signs along with analog arterial waveform data from trauma patients meeting major activation criteria using a prospective study design. Study team members tracked interventions throughout their emergency department stay. RESULTS: Ninety subjects met inclusion with 13 receiving a blood product and 10 a major airway intervention. Most trauma was blunt (69%) with motor vehicle collisions making up the largest proportion (37%) of injury mechanism. Patients receiving blood products had lower CRM values just prior to administration versus those who did not (50% versus 58%, p = .045), and lower systolic pressure (SBP; 95 versus 123 mmHg, p = .005), diastolic (DBP; 62 versus 79, p = .007), and mean arterial pressure (MAP; 75 versus 95, p = .006), and a higher pulse rate (HR; 101 versus 89 bpm, p = .039). Patients receiving an airway intervention had lower CRM values just prior to administration versus those who did not (48% versus 58%, p = .062); however, SBP, DBP, MAP, and HR were not statistically distinguishable (p ≥ .645). CONCLUSIONS: Our results support our hypotheses that the CRM distinguished those patients who received blood or an airway intervention from those who did not, and increased appropriately after interventions were performed. Published 2021. This article is a U.S. Government work and is in the public domain in the USA.
BACKGROUND: The Compensatory Reserve Measurement (CRM) is a novel method used to provide early assessment of shock based on arterial wave form morphology changes. We hypothesized that (1) CRM would be significantly lower in those traumapatients who received life-saving interventions compared with those not receiving interventions, and (2) CRM in patients who received interventions would recover after the intervention was performed. STUDY DESIGN AND METHODS: We captured vital signs along with analog arterial waveform data from traumapatients meeting major activation criteria using a prospective study design. Study team members tracked interventions throughout their emergency department stay. RESULTS: Ninety subjects met inclusion with 13 receiving a blood product and 10 a major airway intervention. Most trauma was blunt (69%) with motor vehicle collisions making up the largest proportion (37%) of injury mechanism. Patients receiving blood products had lower CRM values just prior to administration versus those who did not (50% versus 58%, p = .045), and lower systolic pressure (SBP; 95 versus 123 mmHg, p = .005), diastolic (DBP; 62 versus 79, p = .007), and mean arterial pressure (MAP; 75 versus 95, p = .006), and a higher pulse rate (HR; 101 versus 89 bpm, p = .039). Patients receiving an airway intervention had lower CRM values just prior to administration versus those who did not (48% versus 58%, p = .062); however, SBP, DBP, MAP, and HR were not statistically distinguishable (p ≥ .645). CONCLUSIONS: Our results support our hypotheses that the CRM distinguished those patients who received blood or an airway intervention from those who did not, and increased appropriately after interventions were performed. Published 2021. This article is a U.S. Government work and is in the public domain in the USA.
Authors: Victor A Convertino; Robert W Techentin; Ruth J Poole; Ashley C Dacy; Ashli N Carlson; Sylvain Cardin; Clifton R Haider; David R Holmes Iii; Chad C Wiggins; Michael J Joyner; Timothy B Curry; Omer T Inan Journal: Sensors (Basel) Date: 2022-03-30 Impact factor: 3.576