Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK; US Army Institute of Surgical Research, Fort Sam Houston, San Antonio, Texas, USA.
Anaesthesia. 2013 Aug;68(8):846-50. doi: 10.1111/anae.12316. Epub 2013 Jun 1.
We assessed acidosis, coagulopathy and hypothermia, before and after surgery in 51 combat troops operated on for severe blast injury. Patients were transfused a median (IQR [range]) of 27 (17-38 [5-84]) units of red cell concentrate, 27 (16-38 [4-83]) units of plasma, 2.0 (0.5-3.5 [0-13.0]) units of cryoprecipitate and 4 (2-6 [0-17]) pools of platelets. The pH, base excess, prothrombin time and temperature increased: from 7.19 (7.10-7.29 [6.50-7.49]) to 7.45 (7.40-7.51 [7.15-7.62]); from -9.0 (-13.5 to -4.5 [-28 to -2]) mmol.l⁻¹ to 4.5 (1.0-8.0 [-7 to +11]) mmol.l⁻¹; from 18 (15-21 [9-24]) s to 14 (11-18 [9-21]) s; and from 36.1 (35.1-37.1 [33.0-38.1]) °C to 37.4 (37.0-37.9 [36.0-38.0]) °C, respectively. Contemporary intra-operative resuscitation strategies can normalise the physiological derangements caused by haemorrhagic shock.
我们评估了 51 名因严重爆炸伤接受手术的作战部队的酸中毒、凝血功能障碍和低体温，分别在手术前后进行。患者输注了中位数（IQR[范围]）为 27（17-38[5-84]）单位浓缩红细胞、27（16-38[4-83]）单位血浆、2.0（0.5-3.5[0-13.0]）单位冷沉淀和 4（2-6[0-17]）单位血小板。pH 值、碱剩余、凝血酶原时间和温度升高：从 7.19（7.10-7.29[6.50-7.49]）增加到 7.45（7.40-7.51[7.15-7.62]）；从-9.0（-13.5 至-4.5[-28 至-2]）mmol.l-1 增加到 4.5（1.0-8.0[-7 至+11]）mmol.l-1；从 18（15-21[9-24]）秒增加到 14（11-18[9-21]）秒；从 36.1（35.1-37.1[33.0-38.1]）°C 增加到 37.4（37.0-37.9[36.0-38.0]）°C。当代术中复苏策略可以使出血性休克引起的生理紊乱正常化。
