%0 Journal Article
%T The role of pre-hospital blood gas analysis in trauma resuscitation
%A Milla Jousi
%A Janne Reitala
%A Vesa Lund
%A Ari Katila
%A Ari Lepp£¿niemi
%J World Journal of Emergency Surgery
%D 2010
%I BioMed Central
%R 10.1186/1749-7922-5-10
%X In a prospective randomised study of 37 trauma patients at risk for severe hypovolaemia, arterial blood gas values were analyzed at the accident site and on admission to hospital. Patients were randomised to receive either conventional fluid therapy or 300 ml of hypertonic saline. The groups were compared for demographic, injury severity, physiological and outcome variables.37 patients were included. Mean (SD) Revised Trauma Score (RTS) was 7.3427 (0.98) and Injury Severity Score (ISS) 15.1 (11.7). Seventeen (46%) patients received hypertonic fluid resuscitation and 20 (54%) received conventional fluid therapy, with no significant differences between the groups concerning demographic data or outcome. Base excess (BE) values decreased significantly more within the hypertonic saline (HS) group compared to the conventional fluid therapy group (mean BE difference -2.1 mmol/l vs. -0.5 mmol/l, p = 0.003). The pH values on admission were significantly lower within the HS group (mean 7.31 vs. 7.40, p = 0.000). Haemoglobin levels were in both groups lower on admission compared with accident site. Lactate levels on admission did not differ significantly between the groups.Pre-hospital use of small-volume resuscitation led to significantly greater decrease of BE and pH values. A portable blood gas analyzer was found to be a useful tool in pre-hospital monitoring for trauma resuscitation.Hemorrhagic shock is commonly defined as a state of insufficient perfusion and oxygen supply of vital organs due to loss of blood volume and impaired cardiac preload [1,2]. In the pre-hospital setting trauma patient's shock resuscitation and its monitoring is usually based on clinical experience, assessment and a few basic parameters such as level of consciousness, blood pressure, heart rate and capillary filling time. Even if these basic clinical parameters are close to normal, shock on a cellular or organ level may be present [3-7]. There is little evidence in the literature on basic interven
%U http://www.wjes.org/content/5/1/10