Enhanced prehospital volume therapy does not lead to improved outcomes in severely injured patients with severe traumatic brain injury.
Abbreviated Injury Scale
Adolescent
Adult
Aged
Blood Coagulation
Blood Volume
Brain Injuries, Traumatic
/ blood
Colloids
/ administration & dosage
Crystalloid Solutions
/ administration & dosage
Emergency Medical Services
Female
Fluid Therapy
Hemoglobins
/ metabolism
Humans
Injury Severity Score
Male
Middle Aged
Prothrombin
/ metabolism
Survival Rate
Young Adult
Hemorrhagic shock, emergency medicine
Prehospital replacement volume
Severe traumatic brain injury
Trauma
Trauma registry
Journal
BMC emergency medicine
ISSN: 1471-227X
Titre abrégé: BMC Emerg Med
Pays: England
ID NLM: 100968543
Informations de publication
Date de publication:
23 01 2019
23 01 2019
Historique:
received:
05
12
2017
accepted:
04
01
2019
entrez:
25
1
2019
pubmed:
25
1
2019
medline:
14
6
2019
Statut:
epublish
Résumé
Whether enhanced prehospital volume therapy leads to outcome improvements in severely injured patients with severe traumatic brain injury (TBI) remains controversial. The aim of this study was to investigate the influence of prehospital volume therapy on the clinical course of severely injured patients with severe TBI. Data for 122,672 patients from TraumaRegister DGU A total of 169 patients per group fulfilled the inclusion criteria. Increasing volume administration was associated with reduced coagulation capability and reduced hemoglobin (Hb) levels (prothrombin ratio: group 1: 68%, group 2: 63.7%; p ≤ 0.04; Hb: group 1: 11.2 mg/dl, group 2: 10.2 mg/dl; p ≤ 0.001). It was not possible to show a significant reduction in the mortality rate with increasing volumes (group 1: 45.6, group 2: 45.6; p = 1). The data presented in this study demonstrates that prehospital volume administration of more than 1500 ml does not improve severely injured patients with severe traumatic brain injury (TBI).
Sections du résumé
BACKGROUND
Whether enhanced prehospital volume therapy leads to outcome improvements in severely injured patients with severe traumatic brain injury (TBI) remains controversial. The aim of this study was to investigate the influence of prehospital volume therapy on the clinical course of severely injured patients with severe TBI.
METHODS
Data for 122,672 patients from TraumaRegister DGU
RESULTS
A total of 169 patients per group fulfilled the inclusion criteria. Increasing volume administration was associated with reduced coagulation capability and reduced hemoglobin (Hb) levels (prothrombin ratio: group 1: 68%, group 2: 63.7%; p ≤ 0.04; Hb: group 1: 11.2 mg/dl, group 2: 10.2 mg/dl; p ≤ 0.001). It was not possible to show a significant reduction in the mortality rate with increasing volumes (group 1: 45.6, group 2: 45.6; p = 1).
CONCLUSIONS
The data presented in this study demonstrates that prehospital volume administration of more than 1500 ml does not improve severely injured patients with severe traumatic brain injury (TBI).
Identifiants
pubmed: 30674281
doi: 10.1186/s12873-019-0221-x
pii: 10.1186/s12873-019-0221-x
pmc: PMC6343344
doi:
Substances chimiques
Colloids
0
Crystalloid Solutions
0
Hemoglobins
0
Prothrombin
9001-26-7
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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