Hemodynamic responses to shock in young trauma Patients

Abou-Khalil, Bassam; Scalea, Thomas M.; Trooskin, Stanley Z.; Henry, Sharon M.; Hitchcock, Robyn

doi:10.1097/00003246-199404000-00020

Cited by 177 publications

(21 citation statements)

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“…Traditional endpoints of resuscitation, including restoration of normal clinical perfusion parameters (i.e., mentation, capillary refill time [CRT], heart rate [HR], peripheral pulse quality, and rectal temperature), blood pressure, and urine output remain the standard of care 2 . However, it has been documented that up to 85% of severely injured human patients have evidence of ongoing tissue hypoxia despite normalization of vital signs, suggestive of occult oxygen (O 2 ) debt (defined as the cumulative deficit in cellular oxygen consumption) 3 and the presence of compensated shock 4 . The need for rapid recognition and correction of this state has prompted the search for more sensitive markers of adequate resuscitation.…”

Section: Introductionmentioning

confidence: 99%

Optimal endpoints of resuscitation and early goal‐directed therapy

Prittie

2006

J Vet Emergen Crit Care

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Objective: To review the available endpoints of shock resuscitation, including traditional perfusion parameters, oxygen‐transport variables, lactate, base deficit (BD), venous oxygen saturation, and gastric mucosal pH, and to discuss the currently accepted methods of assessing successful reversal of oxygen (O2) debt in shock patients. Human‐based studies: Early goal‐directed therapy has unequivocally been shown to positively affect outcome in human patients experiencing cardiovascular shock. However, specific endpoints of resuscitation to target in critically ill patients remain controversial. Reliance on traditional endpoints of resuscitation (heart rate [HR], blood pressure [BP]) appears insufficient in detection of ongoing tissue hypoxia in shock states. A multitude of publications exist suggesting that indirect indices of global (lactate, base deficit, mixed/central venous oxygen saturation), regional (gastric intramucosal pH [pHi]) and cellular (transcutaneous oxygen) oxygenation are more successful in outcome prediction and in assessing adequacy of resuscitative efforts in this patient population. Veterinary‐based studies: While there are several large studies evaluating endpoints of resuscitation in experimental canine shock models, this author was unable to find similar research pertaining to small animal veterinary patients. The few articles in which blood lactate is evaluated for prognostic purposes in canine patients are included in this review. Data sources: Veterinary and human literature review. Conclusions: Optimization of early resuscitative efforts has proven to have a survival benefit in human shock patients, and major strides have been made in determining which endpoints of resuscitation to target in this patient population. Similar clinical trials designed to evaluate indices of ongoing global and regional tissue hypoxia in small animal veterinary shock patients are warranted.

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Section: Introductionmentioning

confidence: 99%

Optimal endpoints of resuscitation and early goal‐directed therapy

Prittie

2006

J Vet Emergen Crit Care

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“…They are not always sufficient for determining whether or not a patient is at risk of going into shock [20]. Moreover, it is difficult for doctors to make decisions regarding the patient's risk factor by combining data from different monitoring technologies [21]. Furthermore, most of these techniques are expensive, difficult to apply, invasive and require complex data processing.…”

Section: Biophotonicsmentioning

confidence: 99%

Novel method for early signs of clinical shock detection by monitoring blood capillary/vessel spatial pattern

Kanawade

Klämpfl

Riemann

et al. 2013

Journal of Biophotonics

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The ability to monitor capillary/vessel spatial patterns and local blood volume fractions is critical in clinical shock detection and its prevention in Intensive Care Units (ICU). Although the causes of shock might be different, the basic abnormalities in pathophysiological changes are the same. To detect these changes, we have developed a novel method based on both spectrally and spatially resolved diffuse reflectance spectra. The preliminary study has shown that this method can monitor the spatial distribution of capillary/vessel spatial patterns through local blood volume fractions of reduced hemoglobin and oxyhemoglobin. This method can be used as a real‐time and non‐invasive tool for the monitoring of shock development and feedback on the therapeutic intervention. (© 2014 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)

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“…10,11 Two other populations that have been studied, assessing end points, have been noncardiac surgical patients and those that are septic. Traditionally, measurements of adequate fluid resuscitation include normalization of the heart rate (HR), blood pressure (BP), and urine output (UOP) in both medical and surgical patient populations.…”

Section: Fluid Deficitsmentioning

confidence: 99%

Fluid balance and resuscitation

2008

Nursing Critical Care

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Hemodynamic responses to shock in young trauma Patients

Cited by 177 publications

References 0 publications

Optimal endpoints of resuscitation and early goal‐directed therapy

Optimal endpoints of resuscitation and early goal‐directed therapy

Novel method for early signs of clinical shock detection by monitoring blood capillary/vessel spatial pattern

Fluid balance and resuscitation

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