Lactate Clearance and Survival Following Injury

Abramson, David L.; Scalea, Thomas M.; Hitchcock, Robyn; Trooskin, Stanley Z.; Henry, Sharon M.; Greenspan, Joshua

doi:10.1097/00005373-199310000-00014

Cited by 624 publications

(336 citation statements)

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“…All patients who corrected the acidosis in the first 24 hours survived. Mortality increased as the time elapsed to normalization was longer [63,64].…”

Section: Endpoints For the Resuscitationmentioning

confidence: 98%

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Critical Care Issues in the Early Management of Severe Trauma

García

2006

Surgical Clinics of North America

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Violent trauma and road traffic injuries kill more than 2.5 million people in the world every year. It has been calculated by the World Health Organization that in 2002 there occurred 1.6 million violent deaths [1] and 1.2 million deaths from traffic injury [2], for a combined mortality of 48 deaths per 100,000 population per year.Most trauma deaths occur at the scene or in the first hour after trauma, with a proportion from 34% to 50% occurring in hospitals [3]. These deaths could be prevented by optimization of trauma care. Preventability of trauma deaths has been reported as high as 76% [4] and as low as 1% in mature trauma systems [5,6].Prehospitalization procedures, elapsed time to hospital arrival are, of course, vital to the whole trauma scenario, but errors made in the in-hospital phase of care are responsible for one third to two thirds of the reported by different authors [7,8]. Of these, intensive care unit (ICU) errors are among the most frequent and significant. Errors in the ICU management of trauma patients were studied by Duke and colleagues [9]. They reported 165 ICU trauma deaths. Two hundred fifty-eight errors occurred in 81 patients (52%), and 134 of them contributed to death in 52 patients (34%). ICU errors were classified as management errors (82%), diagnostic (9%), technique (5%), and system inadequacies (4%). Davis and colleagues [10] identified critical care errors in 30% of 125 trauma deaths with errors. These errors contributed to 48% of all preventable deaths.The most common critical care errors are related to airway and respiratory management, fluid resuscitation, neurotrauma diagnosis and support, and delayed diagnosis of critical lesions [9,10].It is imperative for the general surgeon who takes care of trauma patients to know how to deal with these critical aspects, to reduce preventable morbidity and mortality. In the next segment, the situations in which the participation of the surgeon is crucial, during the initial phases of reanimation and stabilization of the critically traumatized patient will be discussed. Airway and ventilation managementAirway and respiratory management errors are the most common of those identified by several authors [9][10][11] The cardinal manifestation is a sudden or a rapidly progressing desaturation, frequently accompanied by tachycardia and arrhytmias, and occasionally by agitation. Hypertension announces the cardiovascular collapse, and bradicardia appears immediately after the total collapse [12]. The symptoms should not be attributed to agitation when it is present, and other possible causes must be ruled out before. Diagnosing the complication involves a directed physical examination, the analysis of the airway pressures and ventilator volumes, chest radiographs, and sometimes the measurement of arterial blood gases (ABG), and the urinary bladder pressure ( Table 1).The emergency conditions in which the access to the airways must be gained, the displacement to diagnosis areas or operating room and the agitation, often present, make the critical...

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“…All patients who corrected the acidosis in the first 24 hours survived. Mortality increased as the time elapsed to normalization was longer [63,64].…”

Section: Endpoints For the Resuscitationmentioning

confidence: 98%

“…All patients who corrected the acidosis in the first 24 hours survived. Mortality increased as the time elapsed to normalization was longer [63,64].Other measurements of metabolic acidosis have shown a correlation with mortality [65,66]. The most extensively studied is base deficit.…”

mentioning

confidence: 99%

Critical Care Issues in the Early Management of Severe Trauma

García

2006

Surgical Clinics of North America

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“…Accordingly, the ability to determine which patients will progress to irreversibility is not accurate. With evaluation of laboratory measures such as base deficit and lactate, clinicians can gauge the magnitude of oxygen debt [Moomey 1999] [Abramson 1993] [Rutherford 1992] [Siegel 2003]. However, alone these laboratory measures alone do not accurately predict irreversibility and are not available to medics in the field.…”

Section: Introductionmentioning

confidence: 99%

Use of Near-Infrared Spectroscopy in Early Determination of Irreversible Hemorrhagic Shock

Taylor

Mulier

Myers

et al. 2005

The Journal of Trauma: Injury, Infection, and Critical Care

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“…6 For each of the three renal areas, three Doppler measurements were taken, and the mean values were then averaged to derive an index for the whole organ in order to minimize sampling error. Pulsed wave Doppler spectrum was increased by using the lowest frequency shift range that did not cause aliasing and the wall filter was set at a low frequency To minimize sampling error, the pulsed wave Doppler spectrum was increased by using the lowest frequency shift range that did not cause aliasing and the wall filter was set on a low frequency (100 MHz).…”

Section: Exclusion Criteriamentioning

confidence: 99%

Early detection with renal Doppler resistive index measurements of hemorrhagic shock in polytrauma patients

Yeslawath

2017

Int J Adv Med

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Background: Poly trauma is a major cause of morbidity and mortality in both developed and developing countries. The aim was to investigate whether renal Doppler RI changes occur early with posttraumatic bleeding and whether the renal Doppler RI may enable accurate prediction of occult hypoperfusion and thus be predictive of the development of hemorrhagic shock in polytrauma patients.Methods: It was a prospective study involving patients admitted in the causality and evaluated by radiology department. Study was done in a period of 6 months from June 2016-December 2016. Renal Doppler RI was measured in 48 hemodynamically stable adult patients admitted in emergency because of polytrauma.Results: 26 patients developed hemorrhagic shock, and 22 did not. Hemorrhagic shock group, as compared with the nonhemorrhagic shock group, had higher renal Doppler RI (mean, 0.79±0.11 [standard deviation] vs 0.61±0.2; P<0.01), injury severity score (mean, 33±12 vs 25±9; P<0.01), and standard base excess (mean, -4.0mEq/L±4 vs 1mEq/L±3; P≤0.05) values. At logistic regression analysis, a renal Doppler RI greater than 0.9 was the only independent risk factor for progression to hemorrhagic shock (P<0.001).Conclusions: Renal Doppler RI measurement may represent a clinically useful non-invasive method for the early detection of occult hemorrhagic shock.

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Lactate Clearance and Survival Following Injury

Cited by 624 publications

References 0 publications

Critical Care Issues in the Early Management of Severe Trauma

Critical Care Issues in the Early Management of Severe Trauma

Use of Near-Infrared Spectroscopy in Early Determination of Irreversible Hemorrhagic Shock

Early detection with renal Doppler resistive index measurements of hemorrhagic shock in polytrauma patients

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