使用简易气动抗休克衣和非气动抗休克衣控制骨盆血流。

Use of an improvised pneumatic anti-shock garment and a non-pneumatic anti-shock garment to control pelvic blood flow.

作者信息

Hauswald Mark, Williamson Michael R, Baty Gillian M, Kerr Nancy L, Edgar-Mied Victoria L

出版信息

Int J Emerg Med. 2010 Jul 21;3(3):173-5. doi: 10.1007/s12245-010-0191-y.

DOI:10.1007/s12245-010-0191-y

PMID:21031041

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2926865/

Abstract

BACKGROUND

Pelvic bleeding from trauma and postpartum hemorrhage is often difficult to treat successfully by emergency providers particularly in low resource environments, when hospital presentation is delayed or there is a lack of immediate surgical, anesthesia, and transfusion capabilities. Pneumatic anti-shock garments (PASG) decrease pelvic blood flow and hemorrhage. A tightly fitted neoprene non-pneumatic anti-shock garment (NASG) has been shown to decrease blood loss and improve survival rates from postpartum hemorrhage.

AIMS

The objective of this study was to determine whether blood flow to the pelvis is decreased by use of the NASG or by an improvised PASG.

METHODS

A PASG was made using three bicycle tubes, placing one tube on each leg and one on the lower abdomen/pelvis, wrapping firmly with sheets and inflating the tubes to approximately 3.5 bar (45 psi). A Doppler ultrasound was used to measure distal aortic blood flow in 12 healthy adults at baseline and in both devices. Data were analyzed with one sample and paired t tests.

RESULTS

Mean flow was 1.99 l/min at baseline. Mean flow decrease was 1.11 [95% confidence interval (CI): 0.64-1.57, p = 0.0003 for the difference] for the PASG and 0.65 (95% CI: 0.03-1.26, p = 0.04) for the NASG. The PASG decreased blood flow more than the NASG (mean difference: 0.46, 95% CI: 0.02-0.90, p = 0.04).

CONCLUSIONS

Both devices decreased distal aortic blood flow, but the improvised PASG device decreased it by a larger margin.

摘要

背景

创伤和产后出血导致的盆腔出血往往难以被急救人员成功治疗，尤其是在资源匮乏的环境中，当患者延迟就医或缺乏即时手术、麻醉和输血能力时。气动抗休克服（PASG）可减少盆腔血流量和出血。已证明一种紧密贴合的氯丁橡胶非气动抗休克服（NASG）可减少产后出血的失血量并提高存活率。

目的

本研究的目的是确定使用NASG或简易PASG是否会减少盆腔血流量。

方法

使用三根自行车内胎制作一个PASG，每条腿上放置一根内胎，一根放在下腹部/骨盆处，用床单紧紧包裹并将内胎充气至约3.5巴（45磅力/平方英寸）。使用多普勒超声在基线时以及在两种装置使用时测量12名健康成年人的远端主动脉血流量。数据采用单样本和配对t检验进行分析。

结果

基线时平均血流量为1.99升/分钟。PASG的平均血流量减少量为1.11[95%置信区间（CI）：0.64 - 1.57，差异p = 0.0003]，NASG为0.65（95%CI：0.03 - 1.26，p = 0.04）。PASG比NASG减少的血流量更多（平均差异：0.46，95%CI：0.02 - 0.90，p = 0.04）。