Diagnostic performance of serial haematocrit measurements in identifying major injury in adult trauma patients

Initial hematocrit in trauma

“…In 1961, Jacobs first described the use of serial Hct in four cases to detect occult blood loss, diagnose hypovolemia, and determine transfusion requirements. 15 More recently, Zehtabchi et al 23 have shown that a decrease in Hct Ͼ5 over 4 hours is a specific predictor of major traumatic injury. Others confirm that serial Hct measurements as early as 15 or 30 minutes apart are specific predictors of bleeding.…”

Hemorrhagic Shock in Polytrauma Patients: Early Detection with Renal Doppler Resistive Index Measurements

“…About 30% more deaths occur within the second or third hour after injury owing to occult major internal hemorrhage ( 3 ). Commonly used parameters suggested for the initial assessment of blood loss in otherwise hemodynamically stable patients, such as the injury severity score (ISS) ( 4 ), markers of hypoperfusion such as lactate level and base defi cits ( 5-7 ), arterial blood pressure, hemoglobin and hematocrit levels ( 8 ), heart rate ( 9 ), and respiratory rate, have been found to have poor sensitivity ( 10 ). Previous studies have shown that in patients treated for trauma, inferior vena cava (IVC) diameter and collapsibility index values are good indicators of blood loss despite normal vital signs at emergency department (ED) admission.…”

Literature Review for Management of Massive Hemorrhage

“…A single Hematocrit or hemoglobin measurement as an isolated laboratory marker for severity of hemorrhage is not recommended and repeated testing is advisable (Grade 1B) [40,41].…”