Rapid assessment of shock in a nonhuman primate model of uncontrolled hemorrhage

Crossland, Randy F.; Mitchell, Alex; Macko, Antoni R.; Aden, James K; Campbell, James E.; Sheppard, Forest R.

doi:10.1097/ta.0000000000000963

Cited by 4 publications

(2 citation statements)

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“…In animal studies, a statistically linear correlation was found between ETCO 2 which measured from the endotracheal tube and partial CO2 in the blood gas [ 9 ]. In another study, it was stated that tissue oxygen saturation and ETCO 2 values are good indicators of acute-phase shock [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Utility of End Tidal Carbon Dioxide to predict hemorrhagic shock in multiple trauma patients

Örmeci¹,

Yiğit²,

Eray³

2021

Turk J Med Sci

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Background/aim: For identifying hemorrhagic shock in trauma patients, some objective data are needed. The use of base excess (BE) and lactate values have been originated. In this study, it was aimed to determine the usability of End Tidal Carbon Dioxide (ETCO₂) in patients with multiple trauma for recognizing hemorrhagic shock. Materials and methods:Patients who were admitted to the emergency department between June 2019 and February 2020 with high-energy multiple trauma were included in the study. ETCO₂ and BE values were measured. Correlation coefficients were calculated to determine correlations between ETCO₂ and BE levels.Results: 122 patients were included in the study. 89 (73%) were men and 33 (27%) were women, and the mean age of the study population was 38.70±19.18. The mortality rate was 14.8% in the study population. The correlation between ETCO₂ and BE values was significant (r: 0,27) and in the same range in the Bland-Altmann analysis. ETCO₂ levels above 35 was specific for stage 1 hemorrhagic shock. ETCO2 levels below 30 were sensitive for stage 2 and 3 hemorrhagic shock and when the levels were measured below 22 it was found specific for stage 4 shock. The specificity increased to 99% at the levels below 18. The sensitivity for ETCO₂ values below 22 for predicting mortality was 33.33%, the specificity was 89.42%, the positive predictive value was 35.29% and the negative predictive value was 88.57%. The sensitivity for BE values below -10 for predicting mortality was 50%, the specificity was 93.27%, the positive predictive value was 56.25% and the negative predictive value was 91.51%.2 Conclusion: ETCO₂ measurement can be a useful parameter as a non-invasive and simple technique in predicting and classifying hemorrhagic shock, which is the leading cause of mortality in trauma patients. Mortality rates increased when ETCO₂ was measured below 22 and these patients are more likely to be in the critical hemorrhagic shock state.

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Section: Discussionmentioning

confidence: 99%

Utility of End Tidal Carbon Dioxide to predict hemorrhagic shock in multiple trauma patients

Örmeci¹,

Yiğit²,

Eray³

2021

Turk J Med Sci

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“…Crossland et al performed 60% left hepatectomy in 16 rhesus monkeys to induce hemorrhage and found that there was a significant difference in ETCO 2 between survivors and nonsurvivors at 5 min after resection, indicating that ETCO 2 is an effective predictor of patient outcomes (37). Campion et al also reached the same conclusion after reviewing the ETCO 2 values of 173 trauma patients before discharge (35).…”

Section: End-tidal Carbon Dioxidementioning

confidence: 99%

Hemorrhagic Shock Assessed by Tissue Microcirculatory Monitoring: A Narrative Review

Yao,

Chen,

et al. 2023

Shock

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Hemorrhagic shock (HS) is a common complication after traumatic injury. Early identification of HS can reduce patients’ risk of death. Currently, the identification of HS relies on macrocirculation indicators such as systolic blood pressure and heart rate, which are easily affected by the body's compensatory functions. Recently, the independence of the body's overall macrocirculation from microcirculation has been demonstrated, and microcirculation indicators have been widely used in the evaluation of HS. In this study, we reviewed the progress of research in the literature on the use of microcirculation metrics to monitor shock. We analyzed the strengths and weaknesses of each metric and found that microcirculation monitoring could not only indicate changes in tissue perfusion before changes in macrocirculation occurred but also correct tissue perfusion and cell oxygenation after the macrocirculation index returned to normal following fluid resuscitation, which is conducive to the early prediction and prognosis of HS. However, microcirculation monitoring is greatly affected by individual differences and environmental factors. Therefore, the current limitations of microcirculation assessments mean that they should be incorporated as part of an overall assessment of HS patients. Future research should explore how to better combine microcirculation and macrocirculation monitoring for the early identification and prognosis of HS patients.

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Sensitive assessment of ETCO2 on circulatory function in critical ill patient — A narrative review

Wen,

Zhang,

Gong

et al. 2024

Trends in Anaesthesia and Critical Care

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Rapid assessment of shock in a nonhuman primate model of uncontrolled hemorrhage

Cited by 4 publications

References 50 publications

Utility of End Tidal Carbon Dioxide to predict hemorrhagic shock in multiple trauma patients

Utility of End Tidal Carbon Dioxide to predict hemorrhagic shock in multiple trauma patients

Hemorrhagic Shock Assessed by Tissue Microcirculatory Monitoring: A Narrative Review

Sensitive assessment of ETCO2 on circulatory function in critical ill patient — A narrative review

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