Chon Sung-Bin, Lee Min Ji, Oh Won Sup, Park Ye Jin, Kwon Joon-Myoung, Kim Kyuseok
Department of Emergency Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.
Department of Emergency Medicine, CHA Bundang Medical Center, Seongnam 13496, Korea.
Korean J Physiol Pharmacol. 2022 May 1;26(3):195-205. doi: 10.4196/kjpp.2022.26.3.195.
Determining blood loss [100% - RBV (%)] is challenging in the management of haemorrhagic shock. We derived an equation estimating RBV (%) via serial haematocrits (Hct, Hct) by fixing infused crystalloid fluid volume (N) as [0.015 × body weight (g)]. Then, we validated it . Mathematically, the following estimation equation was derived: RBV (%) = 24k / [(Hct / Hct) - 1]. For validation, nonongoing haemorrhagic shock was induced in Sprague-Dawley rats by withdrawing 20.0%-60.0% of their total blood volume (TBV) in 5.0% intervals (n = 9). Hct was checked after 10 min and normal saline N cc was infused over 10 min. Hct was checked five minutes later. We applied a linear equation to explain RBV (%) with 1 / [(Hct / Hct) - 1]. Seven rats losing 30.0%-60.0% of their TBV suffered shock persistently. For them, RBV (%) was updated as 5.67 / [(Hct / Hct) - 1] + 32.8 (95% confidence interval [CI] of the slope: 3.14-8.21, p = 0.002, = 0.87). On a Bland-Altman plot, the difference between the estimated and actual RBV was 0.00 ± 4.03%; the 95% CIs of the limits of agreements were included within the pre-determined criterion of validation (< 20%). For rats suffering from persistent, non-ongoing haemorrhagic shock, we derived and validated a simple equation estimating RBV (%). This enables the calculation of blood loss via information on serial haematocrits under a fixed N. Clinical validation is required before utilisation for emergency care of haemorrhagic shock.
在失血性休克的管理中，确定失血量[100% - 红细胞比容（RBV）（%）]具有挑战性。我们通过将输注的晶体液体积（N）固定为[0.015×体重（g）]，根据连续的血细胞比容（Hct，Hct）推导出一个估算RBV（%）的方程。然后，我们对其进行了验证。从数学角度来看，得出了以下估算方程：RBV（%）= 24k / [（Hct / Hct）- 1]。为了进行验证，通过以5.0%的间隔抽取20.0% - 60.0%的总血容量（TBV），在Sprague-Dawley大鼠中诱导非持续性失血性休克（n = 9）。10分钟后检查Hct，并在10分钟内输注生理盐水N毫升。五分钟后再次检查Hct。我们应用线性方程用1 / [（Hct / Hct）- 1]来解释RBV（%）。七只损失30.0% - 60.0% TBV的大鼠持续休克。对于它们，RBV（%）更新为5.67 / [（Hct / Hct）- 1] + 32.8（斜率的95%置信区间[CI]：3.14 - 8.21，p = 0.002， = 0.87）。在Bland-Altman图上，估算的RBV与实际RBV之间的差异为0.00 ± 4.03%；一致性界限的95% CI包含在预先确定的验证标准（< 20%）内。对于患有持续性、非持续性失血性休克的大鼠，我们推导出并验证了一个估算RBV（%）的简单方程。这使得能够通过固定N下的连续血细胞比容信息来计算失血量。在用于失血性休克的紧急护理之前，需要进行临床验证。
