Maningas P A, Mattox K L, Pepe P E, Jones R L, Feliciano D V, Burch J M
Division of Military Trauma Research, Letterman Army Institute of Research, Presidio of San Francisco, California 94129-6800.
Am J Surg. 1989 May;157(5):528-33; discussion 533-4. doi: 10.1016/0002-9610(89)90654-5.
We report the results of the first clinical study on the use of a hypertonic saline-dextran solution for the prehospital management of hypotensive victims of penetrating trauma. During a 4-month period, 48 trauma patients with penetrating injuries and a prehospital systolic blood pressure of 90 mm Hg or less were infused in-field with 250 ml of either a hypertonic saline-dextran solution or the crystalloid plasmalyte A. There were no complications associated with the infusion of the hypertonic saline-dextran solution, and execution of the protocol by paramedic personnel was both safe and uniformly successful. The potential impact of this solution on medical care and the results of this feasibility study justify the initiation of a larger prospective, randomized clinical trial on the efficacy of this solution in the prehospital setting.
我们报告了关于使用高渗盐水-右旋糖酐溶液对穿透性创伤所致低血压患者进行院前处理的首项临床研究结果。在4个月的时间里，48例穿透性损伤且院前收缩压在90毫米汞柱及以下的创伤患者在现场被输注250毫升高渗盐水-右旋糖酐溶液或晶体液聚明胶肽A。输注高渗盐水-右旋糖酐溶液未出现相关并发症，护理人员执行该方案既安全又均获成功。该溶液对医疗护理的潜在影响以及本可行性研究的结果证明有必要开展一项更大规模的前瞻性随机临床试验，以研究该溶液在院前环境中的疗效。
