The dynamics of markers of a shock state in traumatic blood loss depending on fluid resuscitation type.
DOI:
https://doi.org/10.26641/2307-0404.2017.4.117672Keywords:
multiple trauma, bleeding, bleeding management, multiple organ failure, liberal fluid resuscitation, restrictive fluid resuscitationAbstract
The aim of the study was to determine the effect of quantitative and qualitative changes in fluid resuscitation on the dynamics of markers of the shock state in patients with multiple trauma. 73 patients with multiple trauma were divided into two groups, depending on the fluid resuscitation type (liberal or restrictive). The parameters of hemodynamics, hourly diuresis, general blood test, coagulogram, acid-base and gas composition of blood were studied. A decrease in the infusion volume in traumatic blood loss due to the restriction of the crystalloids and colloids volume allowed to effectively reduce such manifestations of shock as hypotension, tachycardia and acidosis, to provide an adequate rate of diuresis. In restrictive infusion group the duration of vasopressor support was shorter, the fluctuations in peripheral blood parameters were less pronounced, coagulation normalized earlier, positive water balance was significantly lower, mortality and the number of complications were reduced. Restriction of fluid resuscitation volume allows to successfully treat shock and decrease multiple organ dysfunction, number of complications and mortality.
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