Abstract
Objective:To explore the effectiveness of controlled blood pressure elevation and limited fluid resuscitation in treating patients with multiple injuries in combination with shock in Intensive Care Unit (ICU).Methods:One hundred and sixty-four patients with multiple injuries in combination with shock who were admitted into the ICU of the hospital between June 2014 and November 2017 were selected and divided into an observation group and a control group using random number table, 82 each group. Controlled blood pressure elevation was given to both groups. Moreover, the control group was given conventional fluid resuscitation, while the observation group was given limited fluid resuscitation. The treatment effectiveness and complications were compared between the two groups.Results:The resuscitation time, post-resuscitation PT and post-resuscitation C-reactive protein level of the observation group were significantly lower than those of the control group (P<0.05). The post-resuscitation hemoglobin level of the observation group was significantly higher than that of the control group (P<0.05). The lactate clearance rate (LCR) of the observation group was (0.22±0.01) and (0.37±0.06) respectively three and six hours after fluid resuscitation, which was remarkably different with that of the control group ((0.27±0.03) and (0.51±0.08)) (P<0.05), but the difference became insignificant 24 h after fluid resuscitation (P>0.05). The observation group had significantly lower incidences of complications such as disseminated intravascular coagulation, respiratory distress syndrome and multiple organ dysfunction syndromes of the observation group and death rate than the control group, and the differences had statistical significance (P<0.05).Conclusion:Controlled blood pressure elevation in combination with limited fluid resuscitation is more effective than conventional fluid resuscitation in the treatment of patients with multiple injuries and shock in ICU as it can shorten recovery time, improve microcirculation perfusion and prognosis, and reduce related complications and fatality rate.
Highlights
Multi-injury induced shock is a common emergency and severe disease
Limited fluid resuscitation refers to keeping blood pressure of hemorrhagic shock patients with uncontrolled bleeding within a range which can satisfy the demand of organs on the lowest perfusion but will not cause excessive disturbances to the internal environment and compensatory mechanism by controlling the input quantity and speed of liquid.[7,8]
The results of this study suggested that the recovery time, prothrombin time (PT), C-reactive protein level and HGB of the observation group were (89.7±25.2) minutes, (10.1±1.2) s, (101.7±12.3) ng/L and (102.5±13.0) g/L respectively, which were significantly different with those of the control group; the finding was consistent with the study of Xu.[16]
Summary
Multi-injury induced shock is a common emergency and severe disease. Active bleeding which is difficult to be controlled at first visit due to the severe condition of primary diseases may induce multi-organ functional disturbance and systemic inflammatory response syndrome, which can severely threaten the life safety of patients.[1,2] Previously many researchers considered thatPak J Med Sci September - October 2018 Vol 34 No 5 www.pjms.com.pk 1120 positive fluid resuscitation was needed by patients with multi-injury induced hemorrhagic shock because it could accelerate effective circulation and ensure elevated and stable blood pressure and effective perfusion.[3,4] it is reported that the traditional resuscitation method may cause poor prognosis though it can rapidly recover effective circulating blood volume.[5]People tend to have improved recognition on the pathogenesis of shock and damage control resuscitation in recent years. Multi-injury induced shock is a common emergency and severe disease. Active bleeding which is difficult to be controlled at first visit due to the severe condition of primary diseases may induce multi-organ functional disturbance and systemic inflammatory response syndrome, which can severely threaten the life safety of patients.[1,2] Previously many researchers considered that. Pak J Med Sci September - October 2018 Vol 34 No 5 www.pjms.com.pk 1120 positive fluid resuscitation was needed by patients with multi-injury induced hemorrhagic shock because it could accelerate effective circulation and ensure elevated and stable blood pressure and effective perfusion.[3,4] it is reported that the traditional resuscitation method may cause poor prognosis though it can rapidly recover effective circulating blood volume.[5]. To further explore effective rescue measures, this study enrolled 164 patients with multi-injury induced shock and treated them with controlled blood pressure elevation in combination with limited fluid resuscitation and conventional fluid resuscitation, aiming to improve survival rate and promote recovery
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
