Effect of preoperative limited fluid resuscitation to the patients with traumatic shock

Objective To investigate the effect of preoperative limited fluid resuscitation to the patients with traumatic shock. Methods Eighty-nine patients with multiple injuries complicating with shock were treated in Changhai Hospital between Jan 2002 to Oct 2005 and were randomly divided into 3 groups according to the level of systolic blood pressure (SBP) at preoperative stage: the SBP of Group A and Group B was about 70 and 80 mm Hg, respectively; the SBP of Group C was over 90 mm Hg. Results (1)There was no significant difference in age, gender, injury severity score (ISS), initiated resuscitation time and initiated operation time among three groups. Before surgery, there was significant difference in the amount of fluid resuscitation and also in the amount of infused erythrocyte suspension among Group A, B and C[ (1 687±96) ml, (2 096±87) ml, (2 976±93) ml, respectively, P0.05; and (294±110) ml, (404±113) ml, (798±230) ml, respectively, P0.05)]. (2)The hemoglobin level in Group C [(94±45) g/L] was lower than that in Group A [(110±22) g/L ]and Group B [(103±24) g/L] (P0.05). But there was no significant difference in the level of hemoglobin between Group A and B.(3)There was no significant difference in the incidence of acute renal failure (ARF) among three groups. The incidence of acute respiratory distress syndrome (ARDS) of Group C (31.2%) was higher than that of Group A (16.7%) and Group B (18.2%) (P0.05). The mortality of Group C (34.4%) was higher than that of Group A (12.5%) and Group B (12.1%) (P0.05). Conclusion The results of our study show that the preoperative limited resuscitation in the patients with traumatic shock can reduce the amount of bleeding, incidence of ARDS and mortality.