Diagnosis and monitoring of hemorrhagic shock during the initial resuscitation of multiple trauma patients: A review

被引:133
作者
Wilson, M
Davis, DP
Coimbra, R
机构
[1] Univ Calif San Diego, Med Ctr, Dept Emergency Med, San Diego, CA 92103 USA
[2] Univ Arizona, Dept Emergency Med, Tucson, AZ USA
[3] Univ Calif San Diego, Dept Surg, Div Trauma, San Diego, CA 92103 USA
关键词
trauma; multiple trauma; hemorrhagic shock; monitoring; resuscitation;
D O I
10.1016/S0736-4679(03)00042-8
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
The initial management of the multiple trauma victim requires evaluation for potential hemorrhage and ongoing monitoring to assess the efficacy of resuscitation and avoid complications related to hemorrhagic shock. A variety of strategies exist to assess circulatory status, including hemodynamic monitoring, tissue perfusion measurement, and use of serum markers of metabolism. We review available technologies used to assess fluid status and tissue perfusion in patients with blood loss or hemorrhagic shock, discuss how these methods can be used effectively and efficiently during initial trauma resuscitation to guide therapy and disposition, and suggest directions for future research to improve outcomes by providing more appropriate and timely care and avoiding unnecessary complications. (C) 2003 Elsevier Inc.
引用
收藏
页码:413 / 422
页数:10
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