在重大创伤和结果的初始变化
Steven G Schauer1,2,3, Susannah E Nicholson4, Julie A Rizzo5
1US Army Institute of Surgical Research, JBSA Ft Sam Houston, Ft Sam Houston, Texas.
JAMA network open
|February 25, 2026
概括
创伤患者在急诊室到达时经常经历不平衡. 低血症和高血症都与增加的死亡率和较高的血液产品使用相比正常水平有关.
科学领域:
- 创伤护理 创伤护理
- 紧急医疗 紧急医疗
- 临床生物化学 临床生物化学
背景情况:
- 障碍在创伤患者中很常见,通常与输血有关.
- 关于初始创伤呈现时的水平及其影响的数据有限.
- 现有证据表明,患有不平衡的创伤患者的结果更糟糕.
研究的目的:
- 为了确定在重大创伤后到达急诊室 (ED) 时乱的发生率.
- 调查障碍与患者结果之间的关联.
主要方法:
- 一项前性多中心队列研究,涉及3个I级创伤中心的1270名重大创伤患者.
- 在ED到来后,立即测量了电离水平.
- 低血症,高血症和高血症是使用标准参考范围来定义的.
主要成果:
- 障碍的发生率为22%的低血症,73%的高血症和5%的高血症.
- 在24小时内,低血症的死亡率为11.9%,高血症为4.3%,高血症为22.8%.
- 在水平和死亡率之间观察到U形关系;高血症显示出最糟糕的结果.
结论:
- 包括高血症在内的障碍在严重创伤患者的ED到来时很普遍.
- 低血症和高血症都与增加的死亡率和更高的血液产品消费有关.
- 需要进一步的研究,包括未来的干预试验,以指导实证治疗策略.
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