Carlile Catherine, Wade Charles E, Baraniuk Mary Sarah, Holcomb John B, Moore Laura J
Department of Surgery, University of Texas Medical School at Houston, Center for Translational Injury Research (CeTIR), 6410 Fannin Street UPB 1100, Houston, TX, 77030, USA.
Department of Surgery, University of Texas Medical School at Houston, Center for Translational Injury Research (CeTIR), 6410 Fannin Street UPB 1100, Houston, TX, 77030, USA.
Am J Surg. 2015 Dec;210(6):1070-5; discussion 1075. doi: 10.1016/j.amjsurg.2015.08.006. Epub 2015 Sep 21.
Hemorrhage remains the leading cause of mortality in preventable trauma deaths. Earlier recognition of hemorrhagic shock decreases the time to implementation of life-saving interventions improves patient survival. The presence of hemorrhagic shock is not always apparent using standard vital signs monitoring, a clinical state referred to as occult shock.
This prospective, observational study was performed at Memorial Hermann Hospital in Houston, TX. Prisoners, pregnant women, and patients with burn injuries greater than 20% total body surface area or bilateral upper extremity fractures were excluded. Hutchinson Technologies Spot Check StO2 device was used to measure StO2 values.
StO2 values less than 75% were predictive of the need for blood product transfusions (P < .01) and the need for emergency surgeries. Nearly one-third of patients who presented with a systolic blood pressure 120 mm Hg or more presented with StO2 less than 75% and had a median base deficit of 5 (3 to 6.5).
Admission StO2 measurements less than 75% predict the need for blood products and emergent surgical procedures and may be used as an adjunct method for identifying shock. StO2 measurements can aid where laboratory values are unavailable.
出血仍然是可预防创伤死亡中导致死亡的主要原因。早期识别失血性休克可缩短实施挽救生命干预措施的时间，从而提高患者生存率。使用标准生命体征监测时，失血性休克的存在并不总是明显的，这种临床状态称为隐匿性休克。
这项前瞻性观察性研究在德克萨斯州休斯顿的纪念赫尔曼医院进行。排除囚犯、孕妇以及烧伤面积超过全身表面积20%或双侧上肢骨折的患者。使用哈钦森技术公司的即时检测StO2设备测量StO2值。
StO2值低于75%可预测需要输血（P < 0.01）以及需要进行急诊手术。收缩压在120 mmHg或更高的患者中，近三分之一的患者StO2低于75%，且碱缺失中位数为5（3至6.5）。
入院时StO2测量值低于75%可预测需要输血和急诊手术，可作为识别休克的辅助方法。在无法获得实验室值的情况下，StO2测量可提供帮助。
