Evaluation of the clinical effect of small-volume resuscitation on uncontrolled hemorrhagic shock in emergency

Abstract

ObjectiveThe objective of the present study was to explore the resuscitative effect of small-volume resuscitation on uncontrolled hemorrhagic shock in emergency.MethodsIn this study, the resuscitative effects in 200 trauma patients with uncontrolled hemorrhagic shock in emergency were studied. Half of these patients were infused with hypertonic/hyperoncotic fluid (small-volume resuscitation group, n=100), whereas the rest were infused with Hespan and lactated Ringer’s solution (conventional fluid resuscitation group, n=100). The changes in hemodynamics, coagulation function, blood biochemistry, blood hematology, and the average infusion volume in both the groups were comparatively studied.ResultsIt was found that the hemodynamics were improved in both the groups after resuscitation. Interestingly, compared with trauma patients infused with Hespan and lactated Ringer’s solution, the growth rate, range, and time duration of the mean arterial pressure of the patients in small-volume resuscitation group increased significantly, and the shock index decreased progressively; in the 60th min after the resuscitation, blood index including hemoglobin, hematocrit, red blood cells, white blood cells, and platelet declined, whereas prothrombin time and activated partial thromboplastin time were prolonged in both the groups, but these changes were less obvious in the small-volume group. In addition, the average infusion volume of patients in the small-volume group was less than that of patients in conventional fluid resuscitation group.ConclusionFeatured with small infusion volume and less influence to coagulation function and homeostasis of human body, small-volume resuscitation possesses a significantly higher resuscitative effect. Therefore, trauma patients may have a better chance to maintain the hemodynamic stability and the survival rate, or recovery speed will be increased when traditional aggressive fluid resuscitation is replaced by small-volume resuscitation.

Hydroxyethyl Starch Improves the Prognosis of Rats with Traumatic Shock via Activation of the ERK Signaling Pathway in Lymphocytes

“…Studies discovered that low-dose HES and LR used for fluid resuscitation has a remarkable effect that can better maintain homeostasis, hence significantly improve the survival rate of patients [ 11 ]. Moreover, HES can greatly alleviate the proinflammatory response and immunosuppression that may occur in surgical operations [ 12 ].…”

Association between the effect of controlled fluid resuscitation on massive hemorrhage and expression of human neutrophil lipocalin

“…Uncontrolled hemorrhagic shock (UHS) is a kind of clinically common disease, which is the ‘lethal triad’ with low body temperature, acidosis and coagulation dysfunction as typical pathophysiological changes. Further, its treatment is based primarily on the principle of fluid resuscitation that includes restoration of the blood perfusion and oxygen supply to end organs ( 1 ). The early fluid resuscitation program was based on the Wiggers controlled hemorrhagic shock model ( 2 ).…”

Зміни Показників Антиоксидантно-Прооксидантної Системи В Тканині Легень За Умов Травми Органів Черевної Порожнини, Гіповолемічного Шоку Та Реперфузії Нижніх Кінцівок В Експерименті

“…Патологічні зміни з боку функції легень зали шаються важливим фактором високої смертності в постраждалих після отримання поєднаної травми. Так, в одному з досліджень при розвитку гострого респіраторного дистрес-синдрому смерт ність становила від 34,9 до 46,1 % [15]. Особливо важливим є питання щодо розвитку змін з боку легень у постраждалих з поєднаною травмою та масивною крововтратою, оскільки масивне переливання інфузійних розчинів може бути фактором виникнення змін з боку легеневої тканини.…”