Pre-hospital emergency values of hypertonic-hyperonconic limited resuscitation for traumatic shock

Abstract

Traumatic shock is a serious threat to life and health. The aim of this study is to investigate the effect of different resuscitation fluid compositions on the emergency resuscitation for patients with traumatic shock. Sixty patients were enrolled and divided into two groups, Group A and Group B. The patients in Group A were treated with resuscitation fluid, with 2:1 ratio of crystal (0.9% sodium chloride injection) and colloid (hydroxyethyl starch 40 injection). The patients in Group B were treated with hypertonic sodium chloride hydroxyethyl starch 40 injection (HSH40). Both vital signs and fluid dosage were monitored and recorded. At the beginning of resuscitation (T₀) and 30 min (T₁), 60 min (T₂) and 120 min (T₃) after resuscitation, indicator parameters including hemoglobin (HB), hematocrit (HCT), prothrombin time (PT), arterial blood lacic acid (LA) and C-reactive protein (CRP) were monitored and recorded. Tissue oxygenation and hemodynamic profile were also analyzed. At T₁, T₂and T₃after fluid resuscitation, the heart rates of the patients in Group B were lower than those in Group A, whereas the average arterial pressure in Group B was significantly higher than that in Group A. Notably, significant decreases of HB and HCT were detected at T₁, T₂and T₃compared with T0 in Group A. In contrast, no significant difference was shown in detected HCT at T₂and T₃compared with T₀ in Group B, while the detected HB value was smaller. a statistically significant decrease of LA was detected at T₁, T₂and T₃in Group A and Group B compared with that at T₀. At T₂and T₃in Group A and Group B, a statistically significant increase of PT was detected compared with the beginning of resuscitation. At T₂and T₃after resuscitation, CRP in both Group A and Group B was significantly increased compared with that upon admission to hospital, and was lower in Group B than in Group A