Khasawneh Mohammad A, Zielinski Martin D, Jenkins Donald H, Zietlow Scott P, Schiller Henry J, Rivera Mariela
Division of Trauma Critical Care and General Surgery, Department of Surgery, St. Mary's Hospital, Mayo Clinic, Mary Brigh 2-810, 1216 Second Street SW, Rochester, MN, 55902, USA,
World J Surg. 2014 Aug;38(8):1892-7. doi: 10.1007/s00268-014-2505-3.
Tissue O2 saturation (StO2) is a measure of tissue perfusion and should decrease during active hemorrhage. An initial StO2 value upon trauma center arrival measured concurrently with or prior to vitals, may predict hemorrhagic shock, requiring early blood product transfusion. Our aim was to identify the early StO2 threshold associated with a greater volume of packed red blood cell (PRBC) transfusion 24 h after injury.
All highest tier triage trauma patients from January 2011 to July 2012 were included in this study. The initial StO2 value upon arrival was used for comparison.
A total of 632 patients were considered, 74% of them male with a mean age of 46 years. Initial StO2 values were available for 325 patients. An StO2 value of 65% was determined as the cutoff due to the marked increase in PRBC consumption in 24 h. There were 23 patients (7%) with an StO2 reading <65% compared to 302 patients with values ≥65%. Both groups had similar systolic blood pressure (118 vs. 126) and heart rate (99 vs. 95) in the trauma bay. In addition, there was no difference in the initial hemoglobin, pH, or base deficit. An early StO2 value <65% also led to a greater number of PRBC transfused in 24 h (6.4 vs. 1.7). Regression analysis demonstrated that an StO2 <65% was the only variable associated with a higher PRBC transfusion volume in 24 h (p = 0.01).
An StO2 value <65% correlates with greater requirement for PRBC transfusion 24 h after injury. This suggests that StO2 can be used as an early marker of hemorrhage which may be superior to traditional vital signs in the trauma population.
组织氧饱和度（StO2）是组织灌注的一项指标，在活动性出血期间应会降低。创伤中心接诊时与生命体征同时测量或先于生命体征测量的初始StO2值，可能预测出血性休克，提示需要早期输注血液制品。我们的目的是确定与伤后24小时内更大剂量的浓缩红细胞（PRBC）输注相关的早期StO2阈值。
纳入2011年1月至2012年7月所有最高级分诊的创伤患者。将接诊时的初始StO2值用于比较。
共纳入632例患者，其中74%为男性，平均年龄46岁。325例患者有初始StO2值。由于24小时内PRBC消耗量显著增加，将StO2值65%确定为临界值。StO2读数<65%的患者有23例（7%），而StO2值≥65%的患者有302例。两组在创伤室时的收缩压（118对126）和心率（99对95）相似。此外，初始血红蛋白、pH值或碱缺失无差异。早期StO2值<65%还导致24小时内输注的PRBC数量更多（6.4对1.7）。回归分析表明，StO2<65%是与24小时内更高PRBC输注量相关的唯一变量（p = 0.01）。
StO2值<65%与伤后24小时内对PRBC输注的更大需求相关。这表明StO2可作为出血的早期标志物，在创伤人群中可能优于传统生命体征。
