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[Clinical study on hematocrit used as a predictor for evaluation of resuscitation effect in the early shock stage
Li-ping Zhao1, Yue-sheng Huang, Ting He
1Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, the Third Military Medical University, Chongqing 400038.
Objective:
To explore the clinical significance of hematocrit used as a predictor for diagnosis and evaluation of resuscitation effect in the early shock stage after burn.
Methods:
Clinical data of 131 severely burned patients admitted to our burn unit from January 2000 to December 2011 were retrospectively analyzed. The burn patients were divided into group A (n = 80) and group B (n = 51) based on the hematocrit level at post burn hour (PBH) 24. The hematocrit levels in group A were less than or equal to 0.50, which in group B were higher than 0.50. There were no statistically significant differences between two groups in age, gender, body weight, admission time after burn, total burn area, full-thickness burn area, and degree of inhalation injury (P values all above 0.05). Hematocrit levels in the shock stage were recorded. Total urine output, base excess, and the volume of fluid infused per kg per %TBSA at PBH 24 were recorded. Rates of complication and mortality were recorded. Data were processed with t test, chi-square test, and Wilcoxon rank sum test.
Results:
Hematocrit level of group A at PBH 24 was decreased to about 0.45, while that of group B was decreased to about 0.55. The urine output in group A at PBH 24 [(61 ± 22) mL/h] was higher than that in group B [(53 ± 20) mL/h, t = 2.212, P < 0.05]. Base excess in group A at PBH 24 [(-6.1 ± 2.9) mmol/L] was significantly higher than that in group B [(-9.0 ± 3.8) mmol/L, t = 4.888, P < 0.01]. The volume infused per kg per %TBSA was higher in group A [(1.9 ± 0.4) mL·kg(-1)·%TBSA(-1)] than in group B [(1.7 ± 0.4) mL·kg(-1)·%TBSA(-1), t = 2.472, P < 0.05]. The rates of complication and mortality in group A [11.3%(9/80), 8.8%(7/80), respectively] were significantly lower than those in group B [27.5%(14/51), 21.6%(11/51), with χ(2) values respectively 5.648 and 4.318, P values all below 0.05].
Conclusions:
Hematocrit can indirectly reflect resuscitation effect in the burn shock stage. Whether hematocrit level can be lowered to 0.45-0.50 during the first 24 hours after burn may be an important index for evaluation of fluid resuscitation effect in the early shock stage after severe burn.
