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Fluid and electrolyte deficit with prolonged pneumatic antishock garment application
The Journal of Trauma
|April 1, 1995
Summary
Prolonged use of the pneumatic antishock garment (PASG) in trauma patients leads to greater fluid loss, lactic acidosis, tissue edema, and hyperkalemia compared to untreated hypotension. These negative effects must be considered for extended PASG application.
Area of Science:
- Trauma care
- Emergency medicine
- Physiology
Background:
- Prehospital pneumatic antishock garment (PASG) use has not improved outcomes for trauma victims within 1 hour of surgical care.
- A potential resuscitative role for PASG is suggested for longer transport times (e.g., 4 hours).
Purpose of the Study:
- To assess the fluid and electrolyte cost of treating posthemorrhagic hypotension with prolonged PASG application.
- To compare the effects of 4-hour PASG inflation versus untreated hypotension in a porcine model.
Main Methods:
- Induce hypotension in anesthetized Yorkshire piglets via arterial bleeding.
- Monitor hemodynamics, serum electrolytes, lactate, and limb circumference.
- Compare a group with 4-hour PASG inflation to a control group with untreated hypotension.
Main Results:
- PASG group showed significantly increased serum potassium (hyperkalemia) and lactate (lactic acidosis).
- The PASG group experienced greater tissue edema and required more intravenous fluids post-intervention.
- Shed blood alone was insufficient to restore baseline carotid arterial blood pressure.
Conclusions:
- Prolonged PASG application exacerbates fluid deficit, lactic acidosis, tissue edema, and hyperkalemia.
- These findings necessitate careful consideration regarding the extended use of PASG in managing hypotension.