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Titolo:
Base deficit development and its prognostic significance in posttrauma critical illness: An analysis by the trauma registry of the Deutsche Gesellschaft fur Unfallchirurgie
Autore:
Rixen, D; Raum, M; Bouillon, B; Lefering, R; Neugebauer, E;
Indirizzi:
Univ Cologne, Dept Surg 2, Surg Clin, D-51109 Cologne, Germany Univ Cologne Cologne Germany D-51109 Surg Clin, D-51109 Cologne, Germany Univ Cologne, Dept Surg 2, Biochem & Expt Div, D-51109 Cologne, Germany Univ Cologne Cologne Germany D-51109 Expt Div, D-51109 Cologne, Germany
Titolo Testata:
SHOCK
fascicolo: 2, volume: 15, anno: 2001,
pagine: 83 - 89
SICI:
1073-2322(200102)15:2<83:BDDAIP>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
ABDOMINAL INJURY; SEVERITY; RISK; INDICATOR; VALUES; TRIAL; SHOCK; CARE;
Keywords:
trauma; critical illness; hemorrhage; oxygen debt; base deficit; lactate; hemodynamics; transfusion; coagulation; mortality;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Rixen, D Univ Cologne, Dept Surg 2, Surg Clin, Ostmerheimerstr 200, D-51109 Cologne, Germany Univ Cologne Ostmerheimerstr 200 Cologne Germany D-51109 Germany
Citazione:
D. Rixen et al., "Base deficit development and its prognostic significance in posttrauma critical illness: An analysis by the trauma registry of the Deutsche Gesellschaft fur Unfallchirurgie", SHOCK, 15(2), 2001, pp. 83-89

Abstract

This prospective, multi-center, observational study of 2069 multiple trauma patients evaluated the prognostic significance of the posttrauma base deficit (BD) on hospital and intensive care unit (ICU) admission to hemodynamic changes, volume and transfusion requirements, lactate and coagulation, aswell as mortality. Furthermore, the importance of the ED development throughout a patient's course of critical illness from the time of injury to ICUadmission is analyzed as a prognostic factor for fatal outcome. The data were obtained by the trauma registry of the 'Deutsche Gesellschaft fiir Unfallchirurgie. ' The patients were subdivided into five categories of increasing ED values on hospital and ICU admission: Category I, ED less than or equal to -2; Category II, -2 < ED <less than or equal to> 2; Category III, 2 <ED <less than or equal to> 6; Category IV, 6 < ED <less than or equal to> 10; and Category V, ED > 10. A statistical analysis was performed by means of the ANOVA and chi-square tests. In 1264 (61.1%) of 2069 multiple trauma patients (age 39 +/- 19 years, 70.0% males, injury severity score 22 +/- 13, 18.6% mortality), the ED was documented on hospital and in 1536 (74.2%) patients on ICU admission. At both points in time, an increase in the ED category was associated with a significant decrease in systolic blood pressureand prothrombin time as well as increases in heart rate, lactate level andmortality (P < 0.0001). Also transfusion requirements (Category I: 4.5 +/-7.7 and Category V: 13.7 +/- 13.0 packed red blood cells) increased significantly on hospital admission (P <less than> 0.0001) with a worsening in the ED category. Mortality increased significantly (P < 0.0001) with a worsening of ED from hospital to ICU admission (from a mortality of 13% in patients with a hospital and an ICU admission ED of <6 to 45% in patients with a hospital and an ICU admission ED of >6). These data show that the base deficit is an early available important indicator to identify trauma patients with hemodynamic instability, high transfusion requirements, metabolic and coagulatory decompensation, as well as a high probability of death, The basedeficit development may help to guide an early and aggressive therapy for the trauma/hemorrhage induced tissue hypoxia.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/01/20 alle ore 03:21:09