Permissive hypotensive resuscitation in patients with traumatic hemorrhagic shock

Ho, Kai-Hung; Tarng, Yih-Wen; Chou, Yi-Pin; Lin, Hsing‐Lin

doi:10.1186/s13049-019-0595-5

Cited by 2 publications

(1 citation statement)

References 3 publications

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“…However, subsequent studies have shown that there is no significant difference in the incidence of acute kidney injury between the two resuscitation methods. The researchers analyzed the possible reasons as follows: all patients experienced acute kidney injury of varying degrees during or following trauma (22). Although the controversy and discussion continue, it does not hinder our continuous research on the recovery of restrictive resuscitation.…”

Section: Discussionmentioning

confidence: 99%

Protective effect of restrictive resuscitation on vascular endothelial glycocalyx in pigs with traumatic hemorrhagic shock

Chi¹,

Jiang²,

Chai³

et al. 2022

Ann Transl Med

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Background: Hemorrhagic shock is the leading cause of early traumatic death. Research and discussion on restrictive fluid resuscitation have been ongoing for many years. The purpose of this study was to explore whether restrictive resuscitation can inhibit the shedding of vascular endothelial glycocalyx in the prehospital treatment of traumatic hemorrhagic shock pigs.Methods: Landrace pigs were randomly divided into a restrictive resuscitation group (restrictive group) and a conventional resuscitation group (conventional group), with 6 pigs in each group. The gunshot caused a rupture of the pig's receding right femoral artery, and the average arterial pressure was 40-45 mmHg stable for 30 minutes, which was defined as a successful shock model. The end point of resuscitation in the restrictive group was a mean arterial pressure (MAP) of 55-60 mmHg for 30 minutes, and the end point of resuscitation in the conventional group was a MAP of 70-75 mmHg for 30 minutes. The results of arterial blood gas analysis, hemodynamic indicators, endothelial glycocalyx damage and shedding marker Syndecan1 and soluble thrombomodulin (sTM) expression levels were compared between the two groups of experimental pigs after resuscitation. Results:The two groups of experimental pigs had the same baseline levels before injury in age, body weight, blood loss, cardiac output index, cardiac function index (CFI), extravascular lung water index (ELWI), and pulmonary vascular permeability index (PVPI). The arterial blood gas analysis of the two experimental pigs showed no significant difference in carbon dioxide partial pressure, oxygen partial pressure, blood oxygen saturation, or blood lactic acid after resuscitation. The difference in cardiac output index and CFI at the end of resuscitation between the two groups was not statistically significant; the absolute value and percentage of Syndecan1 level increase in the restrictive resuscitation group were lower than those in the conventional resuscitation group, and the difference was statistically significant.Conclusions: Compared with full resuscitation in a short period of prehospital treatment, restrictive resuscitation can achieve a similar effect in maintaining tissue oxygen supply and can reduce the loss of vascular endothelial glycocalyx to a certain extent.

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Section: Discussionmentioning

confidence: 99%

Protective effect of restrictive resuscitation on vascular endothelial glycocalyx in pigs with traumatic hemorrhagic shock

Chi¹,

Jiang²,

Chai³

et al. 2022

Ann Transl Med

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Hipotensión Permisiva en Trauma

Berrío

́ánchez

Ramírez

et al. 2021

Rev. Médica Risaralda

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Introducción: El shock hemorrágico es una de las causas más comunes de muerte en pacientes con trauma debido a que pone en marcha un círculo vicioso de mecanismos que incluyen hipotermia, acidosis y coagulopatía. Para mitigar estos efectos, se han propuesto estrategias de control de daños, incluido el aporte controlado de líquidos con hipotensión permisiva contemplando metas en la presión arterial sistólica para mantener una adecuada perfusión de los tejidos. Objetivo: Conocer información actualizada acerca del manejo de la hipotensión permisiva en pacientes con trauma. Metodología: Se buscó información en las bases de datos Web-of-Science y Scopus de los últimos cinco años. El resultado arrojó un total de 118 artículos de los cuales se tomaron 30, según los criterios de inclusión y exclusión. Resultados: Todos los artículos consideran el uso de la hipotensión permisiva como una buena opción para el manejo de los pacientes con trauma e hipotensión, sin embargo, difieren en qué momento es adecuado utilizarlo y en qué condiciones se debe realizar. Conclusiones: Si bien la hipotensión permisiva se ha convertido en uno de los pilares fundamentales en el manejo prehospitalario del paciente con trauma, se requieren estudios investigativos en humanos para soportar cuándo y cómo debe utilizarse.

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Permissive hypotensive resuscitation in patients with traumatic hemorrhagic shock

Cited by 2 publications

References 3 publications

Protective effect of restrictive resuscitation on vascular endothelial glycocalyx in pigs with traumatic hemorrhagic shock

Protective effect of restrictive resuscitation on vascular endothelial glycocalyx in pigs with traumatic hemorrhagic shock

Hipotensión Permisiva en Trauma

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