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首页> 外文期刊>Journal of Clinical Medicine Research >Benefits of Initial Limited Crystalloid Resuscitation in Severely Injured Trauma Patients at Emergency Department
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Benefits of Initial Limited Crystalloid Resuscitation in Severely Injured Trauma Patients at Emergency Department

机译：急诊科对严重受伤的创伤患者进行初步有限的晶体复苏的好处

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Background: Whether initial limited crystalloid resuscitation (LCR) benefits to all severely injured trauma patients receiving blood transfusions at emergency department (ED) is uncertain. We aimed to determine the role of LCR and its associations with packed red blood cell (PRBC) transfusion during initial resuscitation.Methods: Trauma patients receiving blood transfusions were reviewed from 2004 to 2013. Patients with LCR (L group, defined as < 2,000 mL) and excessive crystalloid resuscitation (E group, defined as ≥ 2,000 mL) were compared separately in terms of basic demographic, clinical variables, and hospital outcomes. Logistic regression, R-square (R2), and Spearman rho correlation were used for analysis.Results: A total of 633 patients were included. The mortality was 51% in L group and 45% in E group (P = 0.11). No statistically significant difference was found in terms of basic demographics, vital signs upon arrival at ED, or injury severity between the groups. The volume of blood transfused strongly correlated with the volume of crystalloid infused in E group (R2 = 0.955). Crystalloid to PRBC (C/PRBC) ratio was 0.8 in L group and 1.3 in E group (P < 0.01). The correlations between C/PRBC and ED versus ICU versus hospital length of stay (LOS) via Spearman rho were 0.25, 0.22, and 0.22, respectively.Conclusions: Similar outcomes were observed in trauma patients receiving blood transfusions regardless of the crystalloid infusion volume. More crystalloid infusions were associated with more blood transfusions. The C/PRBC did not demonstrate predictive value regarding mortality but might predict LOS in severely injured trauma patients.J Clin Med Res. 2015;7(12):947-955doi: http://dx.doi.org/10.14740/jocmr2355w
机译：背景：最初的有限晶体复苏（LCR）是否对所有在急诊科（ED）接受输血的严重受伤创伤患者有利。我们旨在确定LCR的作用及其在初次复苏过程中与充血红细胞（PRBC）输注的关系。方法：从2004年至2013年对接受输血的创伤患者进行了回顾。LCR患者（L组，定义为<2,000 mL ）和过度的晶体复苏（E组，定义为≥2,000 mL）在基本人口统计学，临床变量和医院结局方面进行了比较。采用Logistic回归，R平方（R2）和Spearman rho相关性进行分析。结果：共纳入633例患者。 L组死亡率为51％，E组为45％（P = 0.11）。在基本人口统计学，到达急诊室时的生命体征或两组之间的损伤严重程度方面，未发现统计学上的显着差异。输血量与E组输注的晶体量密切相关（R2 = 0.955）。 L组的晶体与PRBC（C / PRBC）之比为0.8，E组为1.3（P <0.01）。 C / PRBC和ED与ICU的相关性与通过Spearman rho住院的住院时间（LOS）的相关性分别为0.25、0.22和0.22。结论：无论输注多少晶体，接受输血的创伤患者的观察结果相似。更多的晶体注射与更多的输血有关。 C / PRBC并未显示出关于死亡率的预测价值，但可能预测了严重受伤的创伤患者的LOS。 2015; 7（12）：947-955doi：http://dx.doi.org/10.14740/jocmr2355w

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