Department of Emergency Medicine, Keçiören Training and Research Hospital, Pınarbaşı, SanatoryumCaddesiArdahan Sokak No: 25, 06280, Keçiören/Ankara, Turkey.
Eur J Trauma Emerg Surg. 2022 Feb;48(1):553-557. doi: 10.1007/s00068-020-01463-5. Epub 2020 Aug 18.
Blood donation from healthy donors is used experimental model that surrogates for class 1 hemorrhage in humans. We examined changes in the perfusion index (PI) and plethysmographic variability index (PVI) in healthy blood donors after donating a unit of blood, and we evaluated the usability of these indices in detecting blood loss volumes of less than 750 mL (class 1 hemorrhagic shock trauma patients).
This study is a prospective, cross-sectional study. 180 healthy volunteers aged 18 and over, who donated blood at the local blood bank, were included in the study consecutively. The age, gender, and body mass index of the volunteers were recorded and, before and after the blood donation, the vital signs and perfusion indices were measured.
Of the donors, 61.7% were men (n = 111), and the median age of all donors was 32 (IQR: 21-39). A statistically significant difference was found between the hemodynamic parameters and PIs before and after the blood donation (p < 0.01 for all parameters; median difference of PI [- 1.45, 95% CI: (- 0.9)-( - 2)], median difference of PVI [6, 95% CI: 7.77-4.23].
We evaluated the perfusion indices in the early diagnosis of blood volume loss in patients admitted to the emergency department due to trauma. After the participants donated one unit of blood, we found that their PI decreased and PVI increased compared to the measurements before the blood donation. Considering that major bleeding starts in the very early stage as minor bleeding, it is essential for emergency physicians to recognize class 1 hemorrhagic shock patients. Further, non-invasive and straightforward procedures, such as measuring PI and PVI, can be particularly useful in identifying blood loss volumes of less than 750 mL.
从健康供者献血是用于替代人类 1 级出血的实验模型。我们检查了在健康献血者捐献 1 个单位血液后灌注指数 (PI) 和容积描记变异指数 (PVI) 的变化，并评估了这些指数在检测小于 750 毫升失血量（1 级出血性休克创伤患者）的可用性。
这是一项前瞻性、横断面研究。连续纳入在当地血库献血的 180 名年龄在 18 岁及以上的健康志愿者。记录志愿者的年龄、性别和体重指数，并在献血前后测量生命体征和灌注指数。
献血者中 61.7%为男性（n=111），所有献血者的中位年龄为 32（IQR：21-39）。献血前后血流动力学参数和 PI 存在统计学差异（所有参数均 p<0.01；PI 中位数差值 [-1.45，95%CI：(-0.9)-(-2)]，PVI 中位数差值 [6，95%CI：7.77-4.23]）。
我们评估了创伤后因创伤入住急诊科的患者早期诊断血容量丢失的灌注指数。与献血前相比，参与者捐献 1 个单位血液后，PI 降低，PVI 升高。考虑到大出血在非常早期就开始于轻微出血，急诊医生识别 1 级出血性休克患者至关重要。此外，非侵入性和简单的程序，如测量 PI 和 PVI，可特别有助于识别小于 750 毫升的失血量。
