Effects of fluid resuscitation on thoracoabdominal injury combined with hemorrhagic traumatic shock

Objective To study effects of fluid resuscitation on thoracoabdominal injury combined with hemorrhagic traumatic shock.Method A total of 98 patients,who were treated in Affiliated Zhongshan Hospital of Dalian University from November 2004 to December 2006,were retrospectively analyzed.The patients were diagnozed according to Surgery(fifth edition).Patients were divided into delayed fluid resuscitation group(n= 51)and immediate fluid resuscitation group(n=47).Patients in delayed fluid resuscitation group were given with balanced salt solution for the body to maintain basic requirements.Patients in immediate fluid resuscitation group were rapidly administered with a lot of isotonic crystaUoid and(or)colloid solution after admission. Hemoglobin,platelet count,hematocrit,blood lactic acid,basedeficit,preoperative resuscitation time and mortality were compared between the two groups.Paired t test and variance analysis or x~2 test were used.Results The transfusion fluid volume of delayed group and immediate group was(1586±346)ml,(3520±575)ml, respectively,with P value0.01.There was no difference on systolic blood pressure between delayed group(78±29)mmHg and immediate group(81±24)mmHg.There existed differences before operation on hemoglobin (106.21±20.91 vs 89.10±32.42 g/L),prothrombin time(11.19±2.03 vs 17.37±2.50 s),platelet count (179.44±52.19)×10~9/L vs(105.55±50.67)×10~9/L,hematocrit(28.40±2.31)% vs(20.84±2.58)%,blood lactic acid(at 30 minutes after resuscitation:1.70±0.37 vs 2.44±0.41 mmoL/L;at 60 minutes after resuscitation:3.16±0.42 us 5.73±0.68 mmol/L),basedeficit(at 30 minutes after resuscitation: -4.46±1.15vs-5.78±1.15 mmoL/L;at 60 minutes after resuscitation:-5.46±1.29 vs -9.60±2.71 mmol/L),the resuscitation time(58±26 vs 73±29)minutes,mortality was(11.3 vs 18.9)%. Delayed fluid resuscitation could significanfly improve blood clotting function,perfusion of tissue and organ,reduce mortality,shorten resuscitation time before operation.The effective rate is better in delayed fluid resuscitation than immediate resuscitation fluid.