电离水平对重重多重创伤患者短期预后的影响:一项临床研究
Toshiro Imamoto1, Makoto Sawano1
1Emergency and Critical Care Medicine, Saitama Medical Center, Kawagoe, Japan.
Trauma surgery & acute care open
|July 3, 2023
概括
在接受大规模输血方案 (MTP) 的严重创伤患者中,维持电离 (iCa) 在0.95 mmol/L以上至关重要. 这种纠正可能会改善创伤患者的短期结果和生存率.
科学领域:
- 创伤重症监护中心的重症监护中心.
- 紧急医疗 紧急医疗
- 代谢过程中的代谢.
背景情况:
- 低血是创伤患者死亡率的一个已知的预测因素.
- 严重创伤患者经常接受大规模输血协议 (MTP).
- 血液中电离度 (iCa) 的时间变化可能会影响预后.
研究的目的:
- 研究血液中电离度 (iCa) 的时间变化与严重创伤患者的预后之间的关系.
- 确定iCa水平对接受MTP的患者死亡率的影响.
主要方法:
- 这是一项单一中心,回顾性,观察性研究,对117名重创患者进行了MTP治疗.
- 多变量逻辑回归分析被用来确定28天死亡率的预测因素.
- 关键变量包括初始和最小iCa (iCa_min),年龄,缩血压,GCS得分和补充.
主要成果:
- 最低iCa (iCa_min) 是28天死亡率的重要独立预测指标 (调整后OR为0.03).
- 年龄和格拉斯哥昏迷尺度 (GCS) 评分也预测了死亡率.
- 预测死亡率的最佳iCa_min截止值为0.95 mmol/L (AUC 0.74).
结论:
- 在24小时内将iCa的积极校正到≥0.95 mmol/L可能会改善创伤性出血性休克的结果.
- 维持适当的iCa水平对于管理严重创伤患者至关重要.
- 这项研究强调了iCa在创伤护理中的预后价值.
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